TFW Assistance Request

TFW Assistance Request

All information is required to respond to your request
Date of Fire*

MonthDayYear
Date
HouseApartmentMobile HomeOther
Address of Fire*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County *
Name of Fire Department that Responded*
How many people are displaced?*
How many pets are displaced?*
Please list pet types
Name of Displaced Head of Household*

First NameLast Name
HOH Contact Phone Number*

Area CodePhone Number
HOH Email address*
example@example.com
Did you rent or own?*
What is your Landlord's Name and Contact Number?*
Was your property insured?*
Name of Agent and contact number!*
What are your immediate needs?*
Google PayCash AppI do not use these forms of payment
Enter your digital payment screen name(s):
Upload 4 pics of the fire areas (exterior and interior pictures needed) (required to proceed)*

Browse Files

Cancelof
Please upload a photo of your Driver's license or valid state ID (Front and Back are required)*

Browse Files
This is a verification for monetary donations when they are requested. Cancelof
How did you find out about the TFW Fire Assistance Program?*
Texas Firewalkers aids fire victims through form submission within the first 48 hours after their fire. If your fire was past 48 hours of the time of your request, we will review the request to see if we can be of assistance. A signature is required and states that the information that you have listed above is true. By submitting your fire photos and signing this statement, you release the rights for Texas Firewalkers to use your photos in our informative posts. To move forward with our program, the address your driver's license must match the fire address that you provided. A utility or phone bill may also be use to math you with the fire address.

Due to overwhelming statewide aid requests, we are only able to service Bastrop, Hays, Caldwell, Travis and Williamson counties due to limited funding.
Signature*

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