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Financial Assistance Request (OLD)

Emergency financial assistance requests are intended to support active or reserve military service members, honorably discharged veterans and/or their immediate household families.

We do not support "late on bills". We support EMERGENCY critical and/or unique situations that require financial support.

We work with many community partners who we consider to be sources of solutions. Your request may also be connected to one of our community partners to best serve your needs.

Typical requests range between $50-$250 with a maximum of $250 per person per year. Amounts more than this will be considered on a case by case basis. This allows us to help more service members and veterans.

We ask that all veterans seek financial assistance through their local County Veteran Service Commission first. If after you have sought their resources and were declined, you may reach out to us. Veterans are asked to upload a copy of your Veteran Service Commission denial letter as an attachment to this request. Active duty and Reservists do not need the denial letter.

VERY IMPORTANT: Please attach proof of service such as a DD214, recent LES, or copy of ID. Requests without supporting documentation will be declined.

Also attach a copy of your "BILL or INVOICE" that you are requesting NEOPAT to fund. NEOPAT will only fund directly to the 3rd party bill or invoice. We do not provide cash funding directly to the service member or veteran. Without an attached document, your request will be declined. It is important that the invoice or bill match the PAYEE info included below. The bill should show the Service Member or Veteran's name. DO NOT submit requests until you are prepared to upload the appropriate documentation. Requests lacking the documentation will be declined and will require re-submission.

Normal requests are processed in approximately 2 weeks with checks being made payable and mailed directly to the invoice, lease or utility bill. You will receive an E-mail with a survey once your request has been paid or declined. Please express any gratitude in that survey as it is used to show appreciation to our donors who support financial assistance requests.

We appreciate your service and look forward to assisting you!

Contact Information

Statement of Understanding

I affirm that the "Person in Need" is a United States active or reserve military service member, or honorablly discharged or retired veteran or of their immediate household family. I acknowledge that I may be contacted by a third party non-profit organization or a government agency in order to best serve my request.

Affirm with checkmark

Date of Request

(mm/dd/yyyy)

Have you asked for support through other agencies?

What other agencies have you already contacted for support and what were the reasons for denial. If NEOPAT is your first attempt for support - please note N/A.

Requester

Name of Person Requesting Donation

First Name

Last Name

Requester Email

Verify Email

Requester Phone

Person or Family in Need

Name of Person in Need

First Name

Last Name

Email Address of Person in Need

Verify Email

Cell Phone of Person in Need

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Military Service

Military Title

Rate/MOS

Military Command

Unit

Start Date of Military Service

(mm/dd/yyyy)

Requested Amount

Total Amount Requesting

Please describe the situation you are in, what caused your financial hardship, and what the funds will be used for.

PAYEE(s) (if known) - > Incomplete will cause delay. <

NEOPAT cannot issue a check or cash directly to the individual in need. Rather, the payee must be identified as a separate entity related to either an attached invoice or bill and MUST be included with this request.

In the next section, please include the full name, mailing address, and account number (if applicable) of one or more payees. (Maximum of 2)

If this request is for an unidentified amount or an unidentified payee, such as a home repair or car repair, it is still best to obtain a documented amount first, and then submit with your request.

No request can be approved without us first knowing who we are to pay, how much the request is for and where to send the check.

REQUIRED: The exact supporting documentation such as a utility bill, car loan payment coupon, or a rental lease agreement, matching the Payee Info is required for our treasurer to fund.

We review requests daily, however, we approve them weekly. Please allow 10 days to 2 weeks for check to be mailed to the payee. We will notify you via E-mail if/when your request is approved or declined and a check has been sent.

We genuinely appreciate your service and are more than willing to assist.

PAYEE 1 - Who do we make the check payable to?

Payee 1-Amount Requested

Payee 1 Account Number

Please make sure this number is accurate or N/A

Payee 1 Street Address (Where we send the check)

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

PAYEE 2 - Who do we make the check payable to?

Payee 2-Amount Requested

Payee 2 Account Number

Please make sure this number is accurate or N/A

Payee 2 Street Address (Where we send the check)

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

PAYEE 3 - Who do we make the check payable to?

Payee 3-Amount Requested

Payee 3 Account Number

Please make sure this number is accurate or N/A

Payee 3 Street Address (Where we send the check)

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Date Needed By

(mm/dd/yyyy)

Attachments

REQUIRED DOCUMENTS:

1. The bill you are requesting us to pay.

2. The DD214 or ID card as proof of service

3. Your County Veteran Service Commission denial letter.

PREVENT DELAY - With out proof of service, an attached bill or invoice, or a VSC denial letter - your request will be declined.

Please DO NOT submit requests with out supporting documentation, or your request will be declined and will need to be re-submitted. We can no longer accommodate manual uploads or texts. Please submit correctly the first time.

Requests are processed on the 1st and 15th of each month. Thank you!

Bill 1

Bill 2 (if applicable)

Bill 3 (if applicable)

DD214 or ID card as proof of service

County Veteran Service Commission denial letter

Additional Documents