PCCR Immediate Needs Distribution

Immediate Needs Cash Distribution – Application (Confidential)

The Pine Creek Community Restoration LTRO is pleased to offer an immediate wildfire relief cash disbursement through our United Way of Whitman County Agency partner. We are committed to creating a fair and equitable disbursement process for each affected household, leaning on the advice and best practices of our professional partners, wildfire relief fund managers, and the intentions of our donors.

We anticipate it will take a few days to process these applications. We are working on making sure we do this correctly and consistent with our donor's wishes. Thank you!

If you encounter any technical issues while filling in this form, please email contact@whitmanunited.org.

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* 1. Applicant Information

Name

Mailing Address (Include City, State, and Zip code)

Address of Loss (Include City, State, and Zip code)

Email Address

Phone Number

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* 2. In order to best determine your situation and provide a fair and equitable distribution process, we’ve selected a 4-Tier distribution formula. Please provide as much detail as possible in the box below and check one of the following categories:

tier 1: Partial Loss - Landlord/Renter/Homeowner with some amount of loss. Please explain.

tier 2: Complete Loss - Homeowner/Tenant without children/dependents with complete loss. Please explain.

tier 3: Complete Loss - Homeowner/Tenant with children/dependents with complete loss. Please explain.

tier 4: Other Impact/Loss – Please describe in detail your situation.

Use this comment field to explain:

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* 3. Please list household member's first name and ages

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* 4. By submitting this application you agree that all facts stated are true and up to date. We will be doing our due diligence to prevent duplication of services. Please acknowledge by typing your name and date.