Section 441.58.53. Application for assistance.

To request financial assistance for unmet disaster needs expenses, the household shall complete Form 470-4689, Iowans Helping Iowans Unmet Needs Disaster Assistance Program, and submit the form to the local administrative entity.

       58.53(1) Application forms are available from the local administrative entity. Individuals can find their local administrative entity by calling the rebuild Iowa office toll-free at [phone].

       58.53(2) The application shall include:

        a.           A declaration of the household’s annual gross income.

        b.           A release of confidential information to personnel involved in administering the program.

        c.           An assurance that the household had no insurance coverage for claimed items or services.

        d.           A commitment to refund any part of a grant awarded that is duplicated by insurance or by any other assistance program, such as but not limited to other state assistance, local community development groups, charities or faith-based agencies, the Small Business Administration, or the Federal Emergency Management Administration.

        e.           A copy of a photo identification document for each adult applicant.

        f.            When vehicle damage is claimed, current copies of the vehicle registration and liability insurance card.

[ARC 9130B, IAB 10/6/10, effective 9/15/10; ARC 9313B, IAB 12/29/10, effective 2/2/11]