Forms: Download Financial Assistance Forms | DFA - DFA
Forms
ONLINE APPLICATION
Application Form for Financial Assistance
This application and all supporting documentation should be completed and submitted when requesting financial assistance.
Release of Information
This form needs to be completed by the applicant for financial assistance and each householder member. The intention of this document is to facilitate the delivery of financial assistance by providing authorization for the Department of Financial Assistance to communicate with external organizations.
Authorization of Representative
This form must be completed where a representative will be applying for financial assistance or communicating with the Department on behalf of an applicant, recipient or member of a household.
Application and Assessment
Eligibility Self-Assessment
This form can be completed to determine if you may qualify for financial assistance.
Application Documentation List
Outlines the documents required to be submitted when applying for financial assistance or when circumstances of an applicant, recipient or household change
Application Form for Financial Assistance
This application and all supporting documentation should be completed and submitted when requesting financial assistance.
Application for Financial Assistance - Appendix 1
Appendix 1 is to be completed for additional adult members of the household. If there are multiple adult household members, this form should be completed once per household member.
Application for Financial Assistance - Appendix 2
Appendix 2 is to be completed for additional members of the household who are under 18 years of age. If there are multiple household members who are under 18 years of age, this form should be completed once per household member.
Release of Information
The intention of this document is to facilitate the delivery of financial assistance by providing authorization for the Department of Financial Assistance to communicate with external organizations.
Authorization of Representative
This form must be completed where a representative will be applying for financial assistance or communicating with the Department on behalf of an applicant, recipient or member of a household.
External Organization Referral for Emergency Circumstances
This form can be used by an external organization to provide support for an applicant who is applying for financial assistance due to emergency circumstances.
Medical Form
The purpose of this document is for a medical doctor or medical officer to inform the Department of Financial Assistance whether an individual is able to work, or if they have a temporary or permanent disability.
Reconsideration Form
This form may be completed by an applicant or recipient for financial assistance who is aggrieved by a decision from the Department of Financial Assistance and who seeks a reconsideration of that decision.
Representative
Authorization of Representative
This form must be completed where a representative will be applying for financial assistance or communicating with the Department on behalf of an applicant, recipient or member of a household.
Revoke Authorization of Representative
This form is to be used by an applicant, representative or household member who has authorized a representative for their interactions with the Department of Financial Assistance and would like to revoke that authorization. If a new representative is to be assigned, an Authorization of Representative Form should also be submitted for the new request.
Case Management
Request Change in DFA Assigned Officer Form
This form is for someone who would like to request a change to their assigned officer from the Department of Financial Assistance.
Conditions Monitoring
This form can be used by external organizations to assist the Department of Financial Assistance in monitoring conditions placed on recipients.
Continuation Certificate
This form can be used by older persons and/or adults who are unable to work due to having a permanent disability, who are recipients of financial assistance to renew their services in the following circumstances: 1. The household has only older persons and/or adults who are unable to work due to having a permanent disability. 2. There are no household members who are able to work. 3. Your household’s circumstances have not changed since your last assessment for financial assistance. 4. No other services are being requested.
Change in Circumstances
This form is for an applicant, recipient or household member to notify the Department of Financial Assistance about a change in circumstance within the household. A change in circumstance is anything which could affect a household’s eligibility or receipt of financial assistance, whether temporary or permanent. Where proof of the change of circumstance is available, it must be submitted with this form.
Referral from DFA to External Organization
This form is for the Department of Financial Assistance to refer an applicant, recipient or household member of financial assistance to another community organization.
Document Requisition Form
This form can be used by an applicant or a recipient to request documents and or letters from the department.
Conditions Monitoring Form (2)
Seafarers and Veterans Ex-Gratia Benefit
Application Form for Caymanian Seafarer Ex-Gratia Benefit
This form must is to be completed in order to apply for the Seafarer Ex-Gratia Benefit.
Release of Information – Seafarers/Veterans
This form needs to be completed by Seafarer, Veterans, or their surviving spouse for financial assistance and each householder member. The intention of this document is to facilitate the delivery of financial assistance by providing authorization for the Department of Financial Assistance to communicate with external organizations.
Complaints
MIISD Complaint Policy
Sign In to complete online form
MIISD Complaint Form
Sign In to complete online form
Complaints
MIISD Complaint Policy
MIISD Complaint Form
Forms
Application and Assessment
Eligibility Self-Assessment Guide
Application Document Checklist
Application for Financial Assistance
Release of Information Form
External Organization Referral to DFA for Emergency Circumstances
Medical Form
Reconsideration Form
Representative
Authorization of Representative Form
Revoke Authorisation of Representative Form
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Seafarers and Veterans Ex-Gratia Benefit
Seafarers Ex-Gratia Benefits Policy
Seafarer Ex-Gratia Benefit Application Form
Complaints
MIISD Complaint Policy
Sign In to complete online form
MIISD Complaint Form
Sign In to complete online form