Assist the Officer

Request for Hurricane Harvey Assistance

Participation Disclaimer

Relief through this program is designated for First Responders from Harris County, Texas. An eligible “First Responder” is a licensed law enforcement officer, fire fighter, emergency medical technician, or similar emergency response specialist thus employed full time (40 hours or more per week) by a governmental entity in Harris, County, Texas. Applicants must submit proof of eligibility with this application.

Only one application may be submitted for each family or dwelling. Multiple applications from married applicants, and multiple applications relating to damage to a single home or dwelling may not be considered.

All applications for relief will be considered in the order in which they are received. An application is not considered received until it is completed and all substantiating documentation is submitted.

All applications for relief must be completed and filed by midnight, September 30, 2017. Applications for relief completed after this deadline may not be considered. Supplemental documentation of any application, received after September 30, 2017, may not be considered.

Assist the Officer’s Mission

Assist the Officer (“ATO”) is a 501(c)(3) non-profit organization established to provide financial assistance to Houston police officers who have been injured or disabled in the line of duty, or who are suffering a critical health or disability related need. However, during instances of natural disasters, ATO extends financial relief to the Professional First Responders of Harris County.

ATO will review and evaluate this application based solely on the information provided by applicant. All requests for assistance will be evaluated based on need and circumstances, without regard to race, national origin, religion, gender, or sexual orientation. No part of the application process should be considered a guaranty of benefits. Each application must be considered and adjudicated on its own merits.

Any intentional misrepresentation, or withholding of requested information, may be grounds for dismissal of an application.  This form must be completed, in its entirety, and all requested information must be provided as a prerequisite to consideration of an application. Submission of a completed application is not a guaranty of payment of benefits.

The terms found in this application are defined as follows:

“Professional First Responder of Harris County” means an active, full time (at least 40 hours per week) first responder employed within Harris County.

“Critical Need from Natural Disaster” is a financial need related to property damage because of a Natural Disaster suffered by an active Professional First Responder of Harris County which creates demonstrable economic hardship.

“Financial Impact of Property Damage” prescribes all property is owned by the Professional First Responder of Harris County and any stated dwelling/housing is considered their primary residence.

“Catastrophic Loss” is the complete destruction, beyond any reasonable ability to be repaired or renovated, of the Professional First Responder’s home. The home must be owned by, and the primary domicile of, the First Responder.

Privacy Policy
Each application for benefits, and all information submitted therewith, is legally privileged and confidential information which is gathered and maintained only for the consideration of the application in question. The information submitted with each application is kept confidential and any use, dissemination, distribution or reproduction of such information is strictly prohibited.

ATO Relief

I. Applicant

City
State/Province
Zip/Postal

II. Employment Information

III. Benefits Requested

Supporting documentation must be submitted for each type of loss claimed. Supporting documentation includes photographs of damage, receipts for items lost, receipts for replacement items, and damage assessments from certified adjusters or appraisers. Use the “upload documents” function below to submit supporting documents or physically attach to hardcopy application being submitted.

Check one of the following:

If you are a renter

Dwelling Contents Over $1,000: More than $1,000 worth of the contents of your dwelling were destroyed by the natural disaster. Only renters are eligible for Dwelling Contents relief. Applicants must submit a lease agreement or other documentation (such as utility bills) proving that they lease or rent the premises incurring damage. “Contents” includes furniture, equipment, electronics, supplies, appliances, tools, etc. Use the “upload documents” function below to submit supporting documents or physically attach to hardcopy application being submitted.

If you are a homeowner

Structure and Contents Over $5,000: Your home incurred more than $5,000 of structural damage and/or loss of contents caused by the natural disaster. To be eligible for relief based on damage to home, the home in question must be owned by, and the primary residence of, the applicant. Renters are not eligible for Home Contents and Structure relief. Applicants must submit proof of ownership and primary residency in the home, such as deeds, mortgage agreements, property tax statements, homestead exemption notice, etc. Use the “upload documents” function below to submit supporting documents or physically attach to hardcopy application being submitted.

Catastrophic Loss. Your home was completely destroyed, and cannot be repaired or renovated.To be eligible for relief based on Catastrophic Loss, the home in question must be owned by, and the primary residence of, the applicant. Renters are not eligible for Catastrophic Loss relief. Applicants must submit proof of ownership and primary residency in the home, such as deeds, mortgage agreements, property tax statements, homestead exemption notice, etc. Applicant must also submit a statement from a licensed adjuster, appraiser, or structural engineer establishing that the home has been completely destroyed, and cannot be repaired or renovated to remediate damage caused by this natural disaster. Use the “upload documents” function below to submit supporting documents or physically attach to hardcopy application being submitted.

Drop a file here or click to upload Choose File
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All information provided is accurate to the best of my knowledge.

I hereby affirm, under penalty of perjury, that all information submitted in and with this application for disaster relief is true and correct. I certify that the losses described were incurred by me and relate to my primary dwelling. I certify that no other member of my family or household has applied for natural disaster relief through this program. I understand that if I submit fraudulent information, with the intention of obtaining charitable relief for which I know I am not eligible, I may be subject to criminal prosecution.