[INFORMATION] The Paleto Bay Relief Request Form

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• THE PALETO BAY RELIEF REQUEST FORM

The Paleto Bay Relief Request Form

The Office of The Mayor has issued $1.5 Million in relief funds for residents who suffered destroyed or uninhabitable homes due to the Paleto Bay fires. Rooms are available at the Sacred Heart Homeless Shelter. For those who prefer hotel or motel accommodations, the City will provide up to $5,000 in reimbursement for stays within hotels and motels in the City or County and $2,000 for transportation to stay in Sacred Hearts and Haven Homes. We are committed to ensuring that our residents have immediate access to safe housing .

The Paleto Bay Relief Effort Program

I. PERSONAL INFORMATION

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• 1.1 First name:

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• 1.2 Middle name(s):

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• 1.3 Last name:

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  1.4 Phone number:

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  1.5 Address:

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  1.6 Bank Routing Number:

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  1.7 Are you applying for hotel stay or transportation to government shelter reimbursement?

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  1.8 Are you a household with children or non-family household? (List under 18 dependents and spouses if any)

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  ACKNOWLEDGEMENT & AUTHORIZATION

  
  

  By submitting this application, I, Full Name, hereby certify that all the questions contained in this document were met with truthful statements. I fully authorize the investigation of any content shared on this document. I am aware that lying, omitting, plagiarizing, or maliciously adulterating this application will result in an investigation.

  
  

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[PBRE] First name Last name

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[center][url=https://forum.gta.world/en/topic/134597-order-no-002-2024-28th-of-september-2024/]The LSGOV Paleto Bay Relief Effort Request Form[/url][/center]

[br][/br][color=#535a6c][size=150][b]I. PERSONAL INFORMATION[/b][/size][/color][hr][/hr]


[list=none][*][b]1.1 First name:[/b] 
[hr][/hr]
[*][b]1.2 Middle name(s):[/b] 
[hr][/hr]
[*][b]1.3 Last name:[/b] 
[hr][/hr]
[b]1.4 Phone number:[/b] 
[hr][/hr]
[b]1.5 Address:[/b] 
[hr][/hr]
[b]1.6 Bank Routing Number: [/b] 
[hr][/hr]
[b]1.7 Are you applying for hotel stay or transportation to government shelter reimbursement?[/b] 
[hr][/hr]
[b]1.8 Are you a household with children or non-family household? (List under 18 dependents and spouses if any)[/b] 
[hr][/hr]

[br][/br][br][/br][accordionfixed=15;ACKNOWLEDGEMENT & AUTHORIZATION]
[br][/br][justify]By submitting this application, I, [b]Full Name[/b], hereby certify that all the questions contained in this document were met with truthful statements. I fully authorize the investigation of any content shared on this document. I am aware that lying, omitting, plagiarizing, or maliciously adulterating this application will result in an investigation.[/justify][br][/br][/accordionfixed][/divbox]