+1 918-678-2297
8 Turtle Drive, Wyandotte, OK 74370

Elder Assistance Application

Family Services

Elder Assistance

This field is for validation purposes and should be left unchanged.

Program Guidelines

Wyandotte Nation Tribal Citizens nationwide, 55 and older, are eligible for a maximum benefit of $350. You should be as thorough and specific as possible in your responses. Incomplete or noncompliant applications will be returned.

Due Dates

The Program Year is from October 1 to September 30. All applications and receipts must be turned in or postmarked by the deadline date.

Receipt Rules

All Receipts MUST have the Following: DATE, ITEM, ITEM PRICE, SUBTOTAL, TAX, TOTAL AND PAYMENT METHOD. Do Not turn in any receipt we cannot see, due to being torn, smudged or is too tiny. Please do not alter receipts by writing on them, highlighting or taping them.

Proof of Payment

Examples of Proof of Payment include: Store Receipts, Copy of Front and Back of Canceled/Cleared Check, Copy of Debit or Credit Statement Showing the Item(s) Purchased. Please do not turn in any store invoice that does not show paid. Paying with Cash must be reflected as paid with a zero balance. Handwriting the check number or “paid”, on the invoice, will not be accepted.

Eligible Payments

Examples of eligible items include, but are not limited to: Household expenses, Utilities, Rent, Auto Repair, Groceries, Fuel, etc.

Non-Eligible Items

We cannot reimburse for these items: Credit Card Statement payments, Cash back at register, Gift cards, Alcohol, Cigarettes, Tobacco, Restaurant tip not recorded on the final receipt, Benny card purchases or Utility bill that the Sr Energy Program paid.

Direct Deposit for Reimbursement

If you have Direct Deposit on file with the tribe, please make sure all banking information is current. If there have been any changes, you will need to submit the proper paperwork before submitting your application.

APPLICATION

Date of Application(Required)
Applicant Name(Required)
Mailing Address(Required)
Is this a new address?(Required)
Date of birth(Required)
Untitled(Required)
(PLEASE EXPLAIN 'WHAT' YOU ARE APPLYING FOR -- DO NOT LEAVE BLANK)

DIRECT REIMBURSEMENT: If you prefer to use the reimbursement program, please send in proof that you have already paid for purchases. Please see program guideline page for eligible forms of payment, and what items may or may not be accepted.

VENDOR: Please list each vendor, provide a copy of the bill or invoice, and state the amount you request we send to that vendor. It is recommended that each $350 allotment is used in full, at once, if paying one or more bills. You will be required to obtain a W9 if the vendor has not previously been paid by the Tribe.

Please provide proof of payment, bill or invoice. Upload the documents or take a picture of the receipts and upload here.
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