Supporting Documentation for Expenses

As part of your grant application, IRS regulations require us to ask for proof of the Event that has impacted you or your eligible dependent (including your spouse/domestic partner), as well as proof of the resulting Expense(s) for which you are seeking assistance. For each Event and Expense category, this guide provides examples of accepted supporting documentation, as well as the information that your documentation must include.

Please provide the documentation listed under the Expense(s) for which you are seeking assistance.

FOOD (immediate needs only – usually applicable 2-4 weeks after Event)

Examples of documentation: grocery invoices/receipts or grocery store Wishlist/Registry showing food items to be purchased.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of food items
• Date of purchase, if relevant

CLOTHING (immediate needs only – usually applicable 2-4 weeks after Event)

Examples of documentation: clothing invoices/receipts or store Wishlist/Registry showing clothing items to be purchased.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of food items
• Date of purchase, if relevant

EVACUATION EXPENSES (reasonable evacuation expenses resulting from Event)

Examples of documentation: invoices/receipts for evacuation expenses (hotel, transportation, food, etc.).

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of evacuation expenses
• Date(s) of service
• Date of payment, if relevant

FUNERAL & BURIAL EXPENSES (reasonable funeral, burial, and relevant travel expenses)

Examples of documentation: invoices/receipts for funeral, burial, and relevant travel expenses.

Documentation must include:

• Name of the deceased
• Name of the person responsible for payment
• Vendor name/address/phone number
• Itemized costs of service(s)
• Provided date(s) of service
• Travel itinerary, if relevant
• Date of payment, if relevant

SIGNIFICANT MEDICAL EXPENSES (not covered by insurance for you or your eligible dependent)

Examples of documentation: invoices/receipts from healthcare provider for medical expenses.

Documentation must include:

• Patient name
• Insurance details
• Vendor name/address/phone number
• Itemized costs of medical expenses
• Date(s) of service
• Date of payment, if relevant

PRESCRIPTION MEDICATION (not covered by insurance for you or your eligible dependent)

Examples of documentation: invoices/receipts from pharmacy for prescription medication.

Documentation must include:

• Patient name
• Insurance details
• Vendor name/address/phone number
• Itemized costs of prescription medication
• Date of purchase, if relevant

MEDICAL TRAVEL EXPENSES

Examples of documentation: healthcare provider statement, invoices/receipts for relevant travel/lodging expenses.

Documentation must include:

• Patient name
• Reason for medical care/travel
• Travel itinerary
• Vendor name/address/phone number
• Itemized costs of medical travel/lodging expenses
• Date(s) of service
• Date of payment, if relevant

RENT (temporary housing up to 30 days)

Examples of documentation: invoices/receipts for temporary housing, such as hotel costs.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of temporary housing such as room rates per day
• Date(s) of service
• Date of payment, if relevant

REASONABLE REPAIRS TO DAMAGED PROPERTY

Examples of documentation: insurance claims, official contractor estimates/invoices/receipts.

Insurance claims must include:

• Your name
• Insurance company name/address/phone number
• Insurance dates of coverage
• Amount covered
• Any deductible amount

Official contractor estimates/invoices/receipts must include:

• Your name
• Vendor name/address/phone number
• Itemized costs of service(s)
• Date(s) of service
• Date of payment, if relevant

ESSENTIAL APPLIANCES & FURNISHINGS

Examples of documentation: invoices/receipts for essential appliances/furnishings or store Wishlist/Registry/Layaway showing items to be purchased.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of essential applicants/furnishings
• Date of purchase, if relevant

ESSENTIAL UTILITIES (gas, water, electricity)

Examples of documentation: invoices/receipts for essential utilities.

Documentation must include:

• Your name
• Vendor name/address/phone number
• Itemized costs of essential utilities
• Date(s) of service
• Date of payment, if relevant

SECURITY DEPOSITS (for new housing if unable to inhabit existing home)

Examples of documentation: photographs of the damaged property, a copy of the signed lease agreement (first and signed pages only).

Documentation must include:

• Your name
• Vendor or landlord name/address/phone number
• Security deposit amount
• Date(s) of lease/new housing

MORTGAGE OR RENT ASSISTANCE FOR PRIMARY RESIDENCE

Examples of documentation: signed lease agreement (first and signed pages only), current monthly mortgage statement.

Documentation must include:

• Your name
• Vendor or landlord name/address/phone number
• Rent/mortgage amount
• Date(s) of lease/mortgage

ADAPTIVE IMPROVEMENTS AND SOLUTIONS (related to Event)

Examples of documentation: invoices/receipts/estimates for adaptive improvements and solutions.

Documentation must include:

• Your name
• Vendor name/address/phone number
• Itemized costs of adaptive improvements and solutions
• Date(s) of service
• Date of payment, if relevant

TRANSPORTATION REPAIRS (other than routine maintenance, or repairs that could not have been avoided)

Examples of documentation: photographs of damages, estimates/invoices/receipts for transportation repairs, car insurance information, total loss of car information.

Estimates/invoices/receipts must include:

• Your name/your eligible dependent’s name
• Vendor name/address/phone number
• Itemized cost of service(s)
• Date(s) of service
• Date of payment, if relevant

Insurance information must include:

• Your name/your eligible dependent’s name
• Insurance dates of coverage
• Amount covered
• Any deductible amount

FOR TOTAL LOSS OF CAR PROVIDE:

• A letter from insurance company stating total loss
• Photographs of car to be purchased showing make and model
• An invoice from the car manufacturer/car exchange including your name/your eligible dependent’s name and the vendor name/address/phone number

PUBLIC OR COMMERCIAL TRANSPORTATION

Examples of documentation: invoices/receipts for public or commercial transportation such as taxis, trains, or buses.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of transportation
• Date(s) of service
• Date of payment, if relevant

CAR RENTAL (up to 30 days)

Examples of documentation: invoices/receipts for car rental.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs of car rental such as rental rate per day
• Date(s) of service
• Date of payment, if relevant

PSYCHOLOGICAL COUNSELING (deemed by a physician to be necessary following Event)

Examples of documentation: invoices/receipts for psychological counseling, healthcare provider statement.

Documentation must include:

• Patient name
• Proof that psychological counseling was deemed necessary by a healthcare provider
• Vendor name/address/phone number
• Date(s) of service
• Date of payment, if relevant

EXPENSES RESULTING FROM FLIGHT FROM DOMESTIC VIOLENCE

Examples of documentation: invoices/receipts for expenses resulting from flight of domestic violence such as temporary housing costs.

Documentation must include:

• Vendor name/address/phone number
• Itemized costs such as housing rates per day
• Date(s) of service
• Date of payment, if relevant

UNABLE TO WORK DUE TO EVENT

Examples of documentation: confirmation letter from manager or company Human Resources representative, healthcare provider statement, FMLA/medical leave documentation, other third-party verification of inability to work due to event.

Documentation must include:

• Your name
• Date(s) unable to work
• Itemized costs of inability to work due to event

UNEXPECTED CHILDCARE (up to 60 days)

Examples of documentation: invoices/receipts for unexpected childcare for your eligible dependent.

Documentation must include:

• Name of eligible dependent
  
• Vendor/address/phone number
• Itemized costs of unexpected childcare
• Date(s) of service
• Date of payment, if relevant