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Funeral Grant Application Form (PDF) - FUNERAL GRANT

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Funeral Grant Application Form (PDF) - FUNERAL GRANT Powered By Docstoc
					                                          DEPARTMENT OF ABORIGINAL AFFAIRS

                                   DISCRETIONARY GRANT APPLICATION FORM

FUNERALS
PERSONAL CONTACT DETAILS
A FAMILY MEMBER (CLOSE OR EXTENDED) MUST APPLY.

 Name:

 Address:

                                                                            Postcode:

 Contact Phone Number:                                                      Fax:

 Relationship to Deceased:

Funds are paid directly to the Funeral Director.
Please attach copy of quote from Funeral Director or provide the following information.

 Date of Funeral:

 Family Name of Deceased:

 Name of Funeral Directors:

 Telephone of Funeral Directors:

The Department of Aboriginal Affairs has a limited fund that can provide small grants to assist
Aboriginal people when no other source of funding is available. Proof of financial hardship may
be requested from the Department.
DECLARATION
I, …………………………………certify that the family is requesting assistance
due to financial hardship. The information given in this application is true and
correct in every detail.

Signature: ………………………….                       Date:…………………………

				
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Description: Funeral Grant Application Form (PDF) - FUNERAL GRANT ...