Realtor Relief Foundation Application for Disaster Relief Assistance

Application for Disaster Relief Assistance

REALTORS® RELIEF FOUNDATION
Type of Assistance
Assistance is available to qualified applicants of Missoula County towards one of the following options:

1) Monthly mortgage expense for the primary residence that was damaged by the Missoula Wind storm or;

2) Rental cost due to displacement from the primary residence resulting from the Missoula Wind Storm or;

3) Hotel reimbursement due to displacement from the primary residence resulting from the Missoula Wind Storm.

Relief assistance is limited to a maximum of $2,000 per household.

Please note that households without a mortgage payment may still be eligible.

Please note this assistance is for housing relief only; other expenses including second mortgages (home equity lines or loans), clothing, appliances, equipment, vehicle purchase, rental or repair, and or mileage are ineligible for reimbursement under this program.
Eligibility

Recipient must be a full-time resident and U.S. citizen or legally admitted for residence in the United States.
Confidentiality

All information provided on this form will remain confidential and will be available only to those who need to confirm eligibility for assistance and to those who process the assistance to be provided. This includes providing a copy of this application to the applicant's lender or landlord, if requested. It will not be shared with other parties for any other purpose.
Disbursement of Funds

In order to provide for a reasonable and equitable distribution of funds, assistance will be provided on a first come, first serve basis. All grants are contingent upon the availability of funds.

Attachment Checklist
Required for All Applicants

1. Photo Identification to Show Proof of Residency [i.e. driver's license or other governmental documentation evidencing residency]

2. Copy of Mortgage Statement or Rent Statement or Lease Agreement or Hotel Receipt.

One of the Following is Required to Show Proof of Damage to your Primary Residence:

a. Photos of Damages.

b. Insurance Estimate.

c. Copies of Written Claims, Settlement Proceeds or Claim Status Reports.

d. Copies of Repair Estimates from Contractors.

PLEASE NOTE: IF THE REQUIRED DOCUMENTS ARE NOT INCLUDED WITH YOUR APPLICATION, YOUR APPLICATION PROCESSING WILL BE DELAYED.

Name*

First NameLast Name
Email*
example@example.com
Street address of Damaged Property:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone*
Please enter a valid phone number.
Other Phone:
Please enter a valid phone number.
Type of Dwelling Damaged:*
Other Type of Dwelling not listed above:
Describe damage/loss relating to your primary residence:*
Total Cost of Damage ($)*
Total Uninsured Loss to Primary Residence ($)*
If displaced from your primary Residence, when do you expect to be able to return to your home?

Please detail any financial assistance you have received from other sources

	Provider	Description of Assistance	Amount Received ($)
1)
2)
3)
4)

Please indicate type of assistance sought*
Hotel Expense Reimbursement:
Amount of monthly housing obligation: MORTGAGE ($):
Amount of monthly housing obligation: RENT ($)

Mortgage Information

	Response
Name of lender/mortgage servicer:
Website address:
Telphone:
Mortgage Loan Account #
Name of Landlord/Property Manager
Telephone of Landlord/Property Manager

IMPORTANT:

PLEASE COMPLETE THIS SECTION IF CURRENT MAILING ADDRESS IS DIFFERENT THAN ADDRESS PROVIDED ON PAGE 3. (EXAMPLE: IF YOU ARE CURRENTLY DISPLACED, WE WILL NEED THIS ADDRESS TO POTIENTIALLY DISTRIBUTE ANY FUNDS.)
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Copy of Photo Identification to show Proof of Residency*

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Copy of Mortgage Statement or New Lease agreement or Hotel Receipt*

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Proof of Damage to Primary Residence (Photos, Insurance Estimates, Claims, Repair estimates from contractors, please including Relevant pages only)*

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Estimates of repair/ Proof of Damage to Primary Residence (Insurance Estimates, Claims, Repair estimates from contractors, please including Relevant pages only)*

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DECLARATION (REQUIRED)
By Signing this application, I am verifing that all the information presented herein is true and correct to the best of my knowledge. I agree that the lender/service provider or landlord listed above may be contacted to verify information contained in this application. I also provided all supplemental documents as required.
Please sign or print your name*
Date*

MonthDayYear
Signature*

Clear
MOR RRF Committee Review recommendation for type of funding:
Recommended Amount ($):
Special Notes from MOR RRF committee review
Should be Empty:

Application for Disaster Relief Assistance

Type of Assistance

Eligibility

Confidentiality

Disbursement of Funds

Attachment Checklist

IMPORTANT:

DECLARATION (REQUIRED)