2020 Northern California Wildfire Relief Application
- Help Phone: (408) 256-0571

- Applications will close on 10/11/2020 11:59 PM PST, or earlier if funding runs out.

- Tzu Chi Foundation is providing Emergency Financial Assistance (EFA) to qualified residents living at residences that were destroyed or severely damaged by the recent wildfires. A valid photo ID and proof of residency will be required to receive the aid if your application is approved.

- If the house is NOT your PRIMARY RESIDENCE, please DO NOT apply.

- If you don't have a valid email address, please enter this email: relief-nc@tzuchi.us
Email address *
First Name *
Middle Name
Last Name *
Gender *
10-digit Mobile Phone Number that can receive text messages *
Format: 7071234567 ( no space, no hyphen)
Please re-enter the same 10-digit mobile phone number for confirmation (Do not Copy and Paste) *
Format: 7071234567 ( no space, no hyphen)
8-digit Red Cross Case #
Numbers only. Please provide if you have it.
9-digit FEMA Registration #
Numbers only. Please provide if you have it.
Date of Birth *
Format: mm/did/yyyy
MM
/
DD
/
YYYY
Driver License *
Format: A1234567 If it's a different format, please enter in the "Comment" section in the last page.
Address of the Residence Affected by Wildfire
Apartment Number (Unit/Suite/Space)of Affected Address
Only for apartments/flats/condos. Skip if none. Format: 1, 2, 3A, 4B, ... etc.
Street Number and Name of Affected Address (No PO Box please) *
Do not include comma or period. Example: 123 Main St
City of Affected Address *
5-digit Zip Code of Affected Address *
When did you evacuate from this residence? *
MM
/
DD
/
YYYY
Approximately, when did you move in this residence as your primary residence? *
Type of Affected Structure *
Level of damage to your residence. Use official information if available. *
Do you have the following insurance? *
Aid will be provided only to the head of the household. One household includes spouse, partner, parents, children, fiance, fiancee, and other relatives living at this same address.
Name of the head of the household at the affected address (First & Last Name) *
How many family members (including yourself) lived at the affected address when the disaster happened? *
1
2
3
4
5
6
7
8+
headcount
List the Name, Gender, Date of Birth, and Relationship of EVERY family member who lived at the affected address when the disaster happened. *
IMPORTANT: If you do not fill out this section correctly, your application evaluation will be delayed. Format: (John Doe, male, 1/2/1950, spouse), (Mary Doe, female, 2/3/1983, daughter), ... or None.
REMINDER: Make sure every family member has the RELATIONSHIP listed in the question above.
For this affected address, you are : *
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