Your benevolent trustees have made your application for benefits easier, with on-line forms!

 

Apply right here for the benefits you need, but first have all your documentation ready! You are able to upload your documentation from within the on-line form. Here is what you need for each type of application.

 

After completing each form you will receive a confirmation email, your application (if complete) will be addressed at the next regular benevolent board meeting held on the second Wednesday of each month. Applicants are encouraged, but not required, to be present at the board meeting where their case will be held. By being present you can answer questions that may arise thus reducing the possibility of a delay in your benefits being approved.

 

Members who have a crisis needing immediate action may also contact a benevolent board member after completing their application to request an expedited approval of their application.

Time Only

 

Items you need

 Your supplemental insurance policy account info (AFLAC)

 

 

 

 

You will need to complete these forms

 

Application for time
Release of information

Release of medical information
and if you have policies
AFLAC release

Financial Assistance


Items you need

Photo of your Drivers License

Digital copy of your last 3 pay stubs

Digital copy of your last two years federal tax returns

Copy of your supplemental insurance policy (AFLAC)

Digital copy of your last 3 bank statements (checking and savings)

 

 

You will need to complete these forms

 

Application for financial assistance
Release of information

Release of medical information
and if you have policies
AFLAC release

Both Financial Assistance & Time

 

Items you need

Photo of your Drivers License

Digital copy of your last 3 pay stubs

Digital copy of your last two years federal tax returns

Digital copy of your supplemental insurance policy (AFLAC etc)

Digital copy of your last 3 bank statements (checking and savings)

 

 

You will need to complete these forms

 

Application for financial assistance

Application for time
Release of information

Release of medical information
and if you have policies
AFLAC release

Digital copies can be photographs, PDF, JPEG, or scans. To avoid a delay in your application being approved all uploaded documents must be complete and legible.

Those wishing to make application for benefits without using our on-line system may download the forms here. Once ALL of the forms are complete, with documentation attached, you can drop them off at our offices or give them to any benevolent board member. Making your application the old fashion way will delay your application, as it must be manually processed. If you have any questions with either the on-line or manual application process you may reach out to any member of the board for guidance.

 

Financial aid only download form

Release of medical information (on-line only)

Release of AFLAC information (on-line only)

 

Time only download form

Release of medical information (on-line only)

Release of AFLAC information (on-line only)

 

Both time and financial aid download form

Release of medical information (on-line only)

Release of AFLAC information (on-line only)