Applications

RCMP Veterans' Association - Foundation » Applications

Asking for financial assistance from peers is a deeply personal situation.

All applications to the Foundation are treated with the upmost respect and confidentiality. All information provided will be kept in the strictest confidence, but a due diligence process is required to review and adjudicate requests for financial assistance.

In most cases, information will be shared within the applicant’s RCMP Veterans’ Association home Division ( usually the home Veterans’ Association Division advocate) to facilitate a review of the information supplied and possibly identify other supports ( Gov and other NGO agency programs) that may be available to the applicant as the circumstances allow for.

Contact and action on applications to the Foundation are primarily handled through the applicant’s RCMPVA home Division.

RCMPVA Foundation Application Process – The application requires as much information as possible as indicated below. Items ONE through FIVE are mandatory. In the case of emergent requests involving $1000.00 or less, information set out in areas one to five may suffice.

ALL applications must include a cover letter or similar document advising of the situation currently being faced and exactly what relief is being sought from the Foundation and if ongoing support outside of a one-time award is being sought.

"*" indicates required fields

Type of Assistance Requested*

Emergency Financial Assistance*

RCMP Veterans’ Association Foundation General Application

* The Emergency Financial Assistance is intended to assist with short-term emergency relief resulting from loss of accommodations and personal possessions that are completely destroyed or not livable/usable for an extended period of time due to fire, smoke or water damage. The emergency assistance, normally to a maximum of $1,000 per qualified applicant, is not intended to compensate for losses incurred, but rather is for making immediate emergency purchases until such time as other agencies commence assistance activities.

Applicant Identification

Name*

First Last

Employee Number

Date of Birth

Status of Applicant at the time of the event giving rise to the assistance request

(e.g. RCMP Member; PSE; Veteran; etc.)

Type of Event

(e.g. fire, flood, etc.)

Address of Residence at the time of the event

Street Address Address Line 2 City Province Postal Code

Address

Street Address Address Line 2 City Province Postal Code

Contact Email*

Phone

Contact Email for Interac e-Transfer*

List of Short-Term Emergency Financial Assistance Needs and Associated Costs

(e.g. Clothing; Food; Accommodation; Pet Supplies; Drugs; Mobility Aids; etc.)

Need #1

Cost #1

Need #2

Cost #2

Need #3

Cost #3

Need #4

Cost #4

Need #5

Cost #5

Former Member Identification

Regiment #

Name

First Last

Service From:

Service To:

If Applicable: Date Deceased

Next of Kin

First Last

Relationship

Background Information

Reason for the application being made

What caused the present situation?

Other Avenues of assistance sought from other agencies and family members

Particulars of persons residing in household:

Name(s) – Relationship – Age – Status – Work/School – Monthly Income – Health Condition

Previous Assistance Obtained

Date(s) Received

Amount(s) Received

Reasons

Specify Disabilities Which Require Special Attention

Please list all disabilities and special considerations requiring further assistance

Specify Outside Assistance Required to Maintain Independent Lifestyle

Please list the assistance required

Assets (Including Spouse/Partner Assets)

Cash on Hand

Savings

Chequing

Money owed to you on demand

Canada Savings Bonds

Investment certificates

Stocks and bonds

Mutual funds

Real estate investments (not including personal residence)

Residence

Business interests

Vehicles (Make, year, value)

Household Furnishings/tools

Collections (e.g. stamps, coins, etc. – approximate value)

Recreational equipment/vehicles

Other assets

Liabilities

Mortgage #1

Mortgage #2

Credit Card #1

Credit Card #2

Credit Card #3

Credit Card #4

Other debt #1 (specify)

Other debt #2 (specify)

Other debt #3 (specify)

Monthly Household Income

RCMP Superannuation

Employment Earnings

Canada Pension Plan (CPP)

Old Age Pension and Supplement(OAS)

Guaranteed Annual Income Supplement (GAIS)

VAC or Disability Gains

General Welfare Assistance

Canada Child Benefit

Employment Insurance

Family Insurance (Life or accident)

Worker’s Compensation

Monthly interest from bank

Interest from investments

Income from family members

Annuity (RRIF/RRSP/TFSA, etc.)

Other income (specify)

Benefit Trust Fund/RCMPVA Foundation

TOTAL MONTHLY INCOME

NOTE: CRA Notice of Assessments MAY BE REQUIRED for all residents of the household as part of the application review process.

Monthly Expenses

Loans

Rent/Mortgage payments

Utilities (electricity, water, phone, electronics)

Fuel for household

Home and auto insurance

Other insurance (life, medical, dental)

Food and personal care

Continuing medical costs (drugs, etc.)

Clothing

Transportation expenses

Household maintenance

Entertainment

Other expenses (specify)

TOTAL MONTHLY EXPENSES

I solemnly declare the above information is true and I hereby consent to the release of any personal information which, in the opinion of the Advocate, the RCMP Benefit Trust Fund and the RCMPVA Foundation, may be deemed necessary in the investigation of my case.

Signature of Applicant

Date

Signature of Spouse/Partner

Date

** As a note, you can just click SUBMIT (the short button on the right) to send your completed application to the Foundation.

** However, if you need to save your application and finish it later, you can click the SAVE Button above (the long button on the left). This will initiate an automated system response email from the RCMPVA Foundation website. Please click on the link in the email to continue your application. To formally submit your COMPLETED application, you must then click SUBMIT on the website.

Applications

Applicant Identification

List of Short-Term Emergency Financial Assistance Needs and Associated Costs

Former Member Identification

Background Information

Particulars of persons residing in household:

Previous Assistance Obtained

Specify Disabilities Which Require Special Attention

Specify Outside Assistance Required to Maintain Independent Lifestyle

Assets (Including Spouse/Partner Assets)

Liabilities

Monthly Household Income

NOTE: CRA Notice of Assessments MAY BE REQUIRED for all residents of the household as part of the application review process.

Monthly Expenses

I solemnly declare the above information is true and I hereby consent to the release of any personal information which, in the opinion of the Advocate, the RCMP Benefit Trust Fund and the RCMPVA Foundation, may be deemed necessary in the investigation of my case.

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