January 2025 Wildfires Disaster Relief​ Financial Assistance Application

The UFLAC is here to help you recover after a disaster.

By submitting this form, we will consider you for financial assistance. A UFLAC Fire Foundation Board Representative will contact you using the information you provided on the form below.

January 2025 Wildfires Disaster Relief​ Financial Assistance Application

Name and Contact Information

First
Last

Pre-Disaster Address

Street Address
Appartment / Unit Number
City
State/Province
Zip/Postal

Current Address

Street Address
Appartment / Unit Number
City
State/Province
Zip/Postal

Household Members

What assistance do you need?

Check all that apply.

Property Damage
Emergency Needs
Other Expenses

By applying to the January 2025 Wildfires Disaster Relief Financial Assistance Foundation Fund, you acknowledge that there is no guarantee that the UFLAC Fire Foundation will provide any financial assistance or specific amount. The UFLAC Fire Foundation has the sole and exclusive discretion to provide assistance, which is limited by the Wildfire Firefighter Support Campaign's funds. By applying for assistance, you authorize the UFLAC Fire Foundation Committee to verify the accuracy of your application.