Palm Beach County 
Firefighter Benevolent
Your benevolent trustees have made your application for benefits easier with on-line forms
Apply right here for the benefits your 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 the possibility of a delay in your benefits being approved.
Members who have a crisis needing immediate action may also contact a 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 etc)
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 complete with documentation attached you can drop them off at our offices or give them to any 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.
Release of medical information
Release of medical information