ESP International Charitable Foundation

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Natural Disaster

The ESP International Charitable Foundation may help employees who are unable to pay for housing, utilities, food, clothing and other basic living expenses because of a natural disaster, such as a wild fire, flood, tornado, hurricane or earthquake that has damaged or destroyed their primary property. The Foundation is not a replacement for insurance, and cannot pay to repair or rebuild houses or other property or for insurance deductibles. Additionally, the program cannot pay to replace non-essential items, such as electronics or furnishings.

 

What's Covered:

 

• Medical expenses (not eligible for reimbursement by insurance)
• Temporary housing
• Security deposit for new rental property
• Limited hotel accommodations to accompany hospitalization qualified dependant
• Past due essentials utility bills (electricity, heat, water, etc.)
• Basic living expenses such as food and clothing

 

What's Not Covered:

 

• Credit card, auto and other debts
• Non-essential utilities (cable, phone, etc.)
• Lost wages Auto repairs or replacement
• Furniture, appliances, electronics Insurance deductibles or insured property losses
• Property repair, rebuilding

 

Assistance Application/Vendors to be paid

 

Date of Natural Disaster*12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 199819992000200120022003200420052006200720082009201020112012201320142015201620172018

Who has been effected by the Natural Disaster?*

Address (Street, City, State, Zip) *

Phone/Cell Number*

E-mail address*

Description of Natural Disaster*

What basic living expense is help needed with?

 Housing

 Clothing

 Food

 Utilities

 Misc

Submitted by*

Vendor name and address*

Basic need provided through service*

Amount Owed*

Date payment due*

Account Number*

Vendor name and address - 2

Basic need provided through service - 2

Amount owed - 2

Date payment due - 2

Account number - 2

Vendor name and address - 3

Basic need provided through service - 3

Amount owed - 3

Date payment due - 3

Account number - 3

Email Address - Who submitted* Send me a copy of form

Important: An insurance report or other related documents regarding the situation must be submitted with this application.

 

 

Document Checklist: (These need to be completed before application is considered)

 

___ Assistance Application

 

___ Incident Report

 

___ List of vendors to be paid

 

___ Additional documentation as requested

 

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