Benevolence Request Form

When Word of Life assists church members or other individuals, the IRS requires the church to keep certain documentation and records on individuals the church has helped. This form should be filled out each time the church helps a person financially. This confidential form will be kept with the church’s financial records.

Applicant Information


For Office Use Only

Applicants for financial assistance are awarded financial assistance based on financial need and availability of funds. Applicants are not granted financial assistance based on relationships between the applicant and church leaders or significant church contributors. The church does not discriminate applicants based upon race, color, sex, national origin, age, geographic territory, or disability. However, the church reserves the right to help those of like precious faith. The church benevolence committee may provide short-term (emergency) assistance and longer-term aid to ensure that victims have the basic necessities such as food, clothing, housing, transportation, and medical assistance (including psychological counseling). The preferred method of providing assistance will be to pay the applicant’s needs directly to a business provider. Assistance may also be provided in the form of cash grants or vouchers for goods or services. The type of aid that is appropriate depends on the individual's needs and available resources.