• Application For Services

    Application For Services

    Cook Inlet Tribal Council Financial Assistance Department
  • Please contact a CITC staff member for assistance at (907) 793-3300.

  • What kind of help do you need?

  • Tribal Temporary Assistance for Needy Families (TANF)

    Purpose: Provides temporary cash assistance for families with children and qualifying Alaska Native or American Indian family members. Qualifying families take part in career planning, training, and/or furthering education with access to child care and other services that support employment, including transportation, interview practice, and money for needed work clothes, tools, and other supplies.

    This program is only for families with children 18 years old and younger living in the home, and or pregnant women in their 3rd trimester of pregnancy.

    Service Area: Municipality of Anchorage (Portage north to Birchwood) and the Matanuska Susitna Borough.

    Income Limitations

    These are household monthly gross (before tax is withheld) income maximums.

    Household Size Explanation Income Maximums
    1  Pregnant Mom in 3rd Trimester $ 1,132.00
    2  1 Child (with one or two adults) $ 1,812.00
    3  2 Child (with one or two adults) $ 2,040.00
    4  3 Child (with one or two adults) $ 2,267.00
    5  4 Child (with one or two adults)  $ 2,496.00
    6  5 Child (with one or two adults) $ 2,724.00
    7  6 Child (with one or two adults) $ 2,951.00
    8  7 Child (with one or two adults) $ 3,181.00
    Each Additonal Household Member   $ 229.00
  • Emergency Short Term Assistance

    Purpose: Provides temporary cash assistance for families with children and qualifying Alaska Native or American Indian family members. Assistance includes rent / mortgage, utility assistance, emergency vehicle repair, emergency home repairs, and other items as determined by need. Participants who have an active Family Cash Assistance (TANF) case should request similar services through their case manager.


    Service Area: Municipality of Anchorage (Portage north to Birchwood) and the Matanuska Susitna Borough.

    Income Limitations:

    These are household monthly gross (before tax is withheld) income maximums.

    Household Size Explanation Income Maximums
    1  Pregnant Mom in 3rd Trimester $ 2,049.00
    2  1 Child (with one or two adults) $ 3,352.00
    3  2 Child (with one or two adults) $ 3,774.00
    4  3 Child (with one or two adults) $ 4,193.00
    5  4 Child (with one or two adults) $ 4,617.00
    6  5 Child (with one or two adults) $ 5,039.00
    7  6 Child (with one or two adults) $ 5,459.00
    8  7 Child (with one or two adults) $ 5,884.00
    Each Additonal Household Member   $ 423.00
  • Adult Financial Assistance / General Assistance

    Purpose: Provides temporary cash support and case management for Alaska Native/American Indian individuals and their families for paying bills, buying food, and making rent/mortgage payments, among other household expenses.

    Service Area: Qualified applicants must reside in the Municipality of Anchorage (Portage north to Birchwood).

    Income Limitations:

    These are household monthly gross (before tax is withheld) income maximums.

    Household Size Income Maximums
    1 $ 906.00
    2  $ 1,812.00
    3 $ 2,040.00
    4 $ 2,267.00
    5 $ 2,496.00
    6 $ 2,725.00
    7 $ 2,954.00
    8 $ 3,183.00
    Each Additonal Household Member $ 229.00
  • Childcare

    Purpose:  Provides child care assistance for Alaska Native/American Indian families needing daycare for children under 13 years of age while parents work, attend training, or take classes

    Service Area: CIRI Region, Municipality of Anchorage, Mat-Su Borrough, Kenai Peninsula Borough, excluding areas served by Ninilchik, Knik, and Kenatize tribes (eligible applicants residing in those areas may apply through their programs).

    Income Limitations:

    These are household monthly gross (before tax is withheld) income maximums.

    Household Size Income Maximums
    1 N/A
    2 $ 5,419.00
    3 $ 5,894.00
    4 $ 6,651.00
    5 $ 7,182.00
    6 $ 7,713.00
    7 $ 8,245.00
    8 $ 8,776.00
    Each Additonal Household Member $ 531.00
  • Youth Services

    Purpose: Youth Services offers programs for Indigenous youth residing in Anchorage, ages 12 - 24, to assist them in finding employment, furthering education, and identifying youth leadership opportunities. Additional programming for youth ages 5 - 11 delivers cultural activities. ASD students are eligible for a grant each school year!

    Youth Employment Program: 10–12-week internships in the spring, fall, & winter. Services include goal setting, career assessment & guidance, employability training, referrals to services, and peer-to-peer support. Ages 14 - 24.

    Youth Case Management: Year-round case management, including career assessments, job search assistance, career & education planning, life skills classes, & one-on-one coaching. Youth who meet low-income criteria may be eligible for gift cards/payment to support employment goals. Ages 12 -24

    Youth Navigation: Fun and educational activities, with an emphasis on cultural activities, for Indigenous youth. Ages 5 - 11

    Service Area: Qualified applicants must reside in the Municipality of Anchorage (Portage north to Birchwood).

    Income Limitations:

    Varies, automatic eligibility includes (if any of these are true you or your family member is eligible):

    • You or your family receives public benefits like TANF or General Assistance Social Security Supplemental Insurance
    • You are experiencing homelessness
    • Your parent is laid off or underemployed for more than 30 days
    • You are underemployed (working less than 30 hours per week)
    • You receive free or reduced price lunch at school
    • Your household has low or no income

     

  • Low Income Heating Assistance Program (LIHEAP)

    Purpose: This program supports payments to Enstar, other utilities or fuel providers for  individuals and families with Alaska Native and American Indian Household members that are unable to pay their heating costs.

    Additionally, in some instances, this program can be used to repair or modify furnaces, water heaters or other home heating system items.

    Service Area: Eligible applicants must live within the Municipality of Anchorage (Portage to Birchwood).

    Income Limits:

    These are household monthly gross (before tax is withheld) income maximums.

    Household Size Income Maximums
    1 $ 2,351.25
    2 $ 3,192.50
    3 $ 4,033.75
    4 $ 4,875.00
    5 $ 5,716.25
    6 $ 6,557.50
    7 $ 7,398.75
    8 $ 8,240.00
    Each Additonal Household Member $ 841.25
  • Information About You

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  • Regional Corporation Affiliation:

  • Answer these questions to see if you get food stamps within seven days

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  • Information about you and the people who live with you

    Please list your information and then add additional household members. Disclosure of your Race and Ethnicity information is voluntary and will not affect your eligibility or level of benefits. This information will be used to assure that program benefits are distributed without regard to race, color or national origin
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  • Child Support Cooperation Section

    TANF Applicants only fill out Questions 22-27
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  • Child Support Cooperation and Assignment of Support


    You are required by law to help get child support for a child receiving Temporary Assistance (ATAP/TANF) payments or medical support for a child receiving medical assistance (Medicaid). This means you must help locate a non-custodial parent or establish paternity for a child with no legal father. You must sign over to the State or Tribe any child/spousal support or medical support owed to you for any months you receive assistance. If the non-custodial parent pays support
    payments to you while you are receiving Temporary Assistance, you must turn the payments over to Child Support Service Division (CSSD). You must do this even if no support order is in effect.

  • Supplying Information to CSSD – Confidentiality and Safety


    If you believe that cooperating with CSSD to get child or medical support will bring harm to you or your children and you can provide support for your belief, you may claim good cause for not cooperating. You will be asked by a case worker to complete “good cause” claim forms. It is up to the caseworker to decide if you have good cause for not cooperating. CSSD will continue to pursue child or medical support against the non-custodial parent, even if you DO NOT cooperate, unless Cook Inlet Tribal Council approves good cause. Please check one of the boxes and sign below.

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  • Medical Assistance

  • Childcare Assistance

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  • Heating Assistance or Weatherization

  • You cannot receive Heating Assistance from both the SOA and Tribal or Native organization

  • Explain how you are paying these costs

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  • A. What is the exterior Length:   * ft. and Width:   * ft.

  • B. How many bedrooms are in your home? (A loft counts as one bedroom)   *   

  • C. How much rent or mortgage do you pay each month?
    Rent: $ * Mortgage: $ * Space Rent: $   *   

  • D. Is your rent based on 30 percent of your income (Subsidized or Section 8)?      *   

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  • E. We may need to contact your landlord or manager to get information to process your application.
    Name of Landlord:   *   *
    Address:   * * * * 
    Phone: * *

  • 44. Questions about your Heating and Electric

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  • 45. Questions about your fuel and/or electric company

  • A. Name of Fuel Company   *   
    Account Number   *   
    Name on Account           
    Amount of Current Bill        

  • B. Name of Electric Company   *   
    Account Number   *   
    Name on Account          
    Amount of Current Bill        

  • Authorized Representative

    An authorized representative (AR) is someone who has written authorization to act on behalf of another person or entity. They can be a trusted person or family member, such as a legal guardian or power of attorney, who is knowledgeable about the applicant's financial affairs.
  • ALTERNATE PAYEE

  • Do not complete this section if you do not want someone else to receive or spend your Family Cash Assistance (TANF).


    I want this person to be able to receieve and spend my Family Cash Assistance on behalf of my household.

  • Release of Information

    • By signing below I give permission to Cook Inlet Tribal Council (CITC) to obtain and release information with Division of Public Assistance for eligibility for services.
    • By signing below I understand CITC will verify information in the Department of Labor Division of Employment Training Services system and Child Support Services Division system.
    • By signing below I understand CITC will verify income and assets though third party vendors.
  • Food Stamps Subsistence Statement - for rural areas only

    Does your household live in a rural community in which access to retail stores is difficult and you intend to rely on subsistence hunting and/or fishing for substantial portion of your food? If so, you may be able to use SNAP benefits to buy subsistence hunting and fishing items such as nets, lines, hooks, fishing rods, and knives.
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  • Read and initial next to each statement below confirming that you understand and agree:

  • I understand that I must be a current Alaska resident to qualify for Public Assistance benefits administered by Cook Inlet Tribal Council, Inc. I further understand that, if my residency status changes, I must report the change to Cook Inlet Tribal Council, Inc within 10 days. I further understand that if I leave the state for 30 or more days, I must notify Cook Inlet Tribal Council, Inc of my absence, regardless of whether I consider myself an Alaska resident/intent to return to Alaska, or not.

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  • I understand that eligibility for CITC Assistance is determined in part by how much income my household has as its disposal. To that end I understand that this application requires that I disclose all income received by myself and members of my household, including but not limited to income from the following sources. Employment (including Self-Employment), Alimony, Child Support, Unemployment, Net Rental/Royalty, Pension/Retirement Supplemental Security Income, Veteran's Benefits, and Social Security Benefits.

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  • I understand that eligibility for CITC Assistance is determined in part by how many assets my household has at its disposal. To that end, I understand that this application requires that I disclose all assets possessed by myself and members of my household, including but not limited to the following types of assets: Property (regardless of whether the Property is paid for, still being paid for, or is jointly owned with someone else), all Bank Accounts (including checking and savings accounts), Cash on Hand, Certificates of Deposit, College Savings Plans, Life Insurance Policies, Pension Plans, Retirement Funds, Stocks Bonds and Annuities, Native Corporation Shares, Trust Funds, Safety Deposit Box contents, Mineral Rights, IRA Accounts, Commercial Fishing Permits, and Burial Policy Agreements.

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  • Your Rights and Responsibilities

  • PARTICIPANT APPEAL (cash assistance programs only)

    If you disagree with an action taken by the CITC Financial Assistance Department which may affect your cash assistance, you may file an appeal within 30 days of the action. During the 30 days of your appeal date, you may continue to receive cash assistance if you request it in writing until a CITC agency appeal decision is made. If the appeal decision is not in your favor, you will be responsible to pay back any extra cash assistance you received while awaiting the appeal decision.

    CITC PARTICIPANTS COMPLAINTS AND FEEDBACK

    If you are unhappy with the services offered, or the way you are treated, you must follow the participant complaints and feedback procedure outlined in CITC Procedure #9.010.010. The first step in either a complaint or feedback is to contact the staff with whom you have acomplaint/feedbackto discuss or attempt to resolve the disputed action. If you are unable to resolve the disputed action with the staff, you then meet with the staff’s supervisor who will work with you to resolve the complaint or receive your feedback. For a complaint, if it remains unresolved, a formal complaint can be filed with the supervisor who will bring that complaint to the appropriate member of leadership for further action. Participants may request a change of case manager based on their personal preference, however at any point in time this may not be possible due to staffing availability.

    CHANGES IN HOUSEHOLD CIRCUMSTANCES

    You must report changes in your household within 10 days of when you learn of the change. You may do this by contacting the CITC office by phone, in person or in writing. Reporting changes such as income and resources or changes in your household to other agencies does not exempt you from reporting changes to CITC. You are required to report the following changes:

    1. Changes in employment-starting or stopping a job, change in wage rate, change from part-time to full-time or full-time to part-time.
    2. Changes in the source of unearned income and changes in the amount of total unearned income greater than $50.00 per month (Examples: Social Security or Unemployment).
    3. When someone moves into or out of your home (If a child is/or going to be absent it must be reported within 5 days).
    4. If you change your residence or get a new mailing address; we need to verify your new shelter costs if you move or we cannot use them in calculating your cash assistance.
    5. If your household gets a vehicle, sells a vehicle or sells any other item to obtain cash.
    6. If your household has more than $2000 in cash or money in bank accounts.
    7. Changes in your legal obligations to pay child support.
    8. Childcare-if changing providers, you must notify our office and you must comply with your provider’s policies.
    9. Please report any other factors you think may affect your case or eligibility for the services.

    WORK/SCHOOL REQUIREMENTS

    Family Cash Assistance (TANF) and General Assistance (GA) are Work First Services. To receive services,you may have to participate in work activities. TANF and GA participants must meet with their case worker and develop a self-sufficiency plan that lists steps you will take to become financially independent. You must participate in approved workactivities unless you qualify for an exemption. If you are employed and voluntarily reduce your hours, income, or quit your job without good cause and do not have approval from the case worker, a job quit penalty may be applied to your case. If you are an unmarried minor parent, to receive Tribal TANF you must live with a parent or in another approved living arrangement and attend school or training. If you have school aged children they must be enrolled, attending school and making progress. Failure to provide school attendance and grade verification reports may result in a penalty being applied to your case. If you do not fulfill these work and education requirements, or minor parent requirements your cash assistance may be reduced or ended. You must also report within 10 days when your child graduates from high school.

    HOME VISITS

    A CITC Compliance Officer may visit your home unannounced between 7:00 am to 8:00 pm to verify all information reported. Cooperation with the Compliance Officer is required. If you do not cooperate with the Compliance Officer home visit, your TANF, GA, Child Care or Heating Assistance case will close. A Case Worker and Eligibility Technician may also conduct a regular home visit. These home visits are scheduled with you or you are given 10 days’ notice prior to the visit. It is in your best interest to cooperate with these home visits. If there is no cooperation, your assistance could be reduced or closed.

    FRAUD PENALTY WARNINGS/OVERPAYMENTS

    You may be prosecuted if you knowingly give false, incorrect, or incomplete information to get or attempt to receive cash assistance, supportive services, or other services through Financial Assistance Department that you may not be eligible for, or to help someone else receive Financial Assistance Department services for which they are not eligible for. By accepting services, you understand and agree that you may have a responsibility of repayment of any services or cash assistance you wrongly received caused by yourself or CITC staff.

    WARNING: Any information you provide to any CITC program may be used against you in a Court of Law or for implementing an Administrative Disqualification Hearing which will result in an Intentional Program Violation disqualification from the above-mentioned services.
    If you misrepresent your residence or identity to receive multiple services to include cash assistance, you can be barred from receiving Tribal TANF for 10 years. Other penalties may also apply.

    EMPLOYMENT & SUPPORTIVE SERVICES

    If your cash assistance case closes due to earnings,or you are found ineligible for services you may still be eligible for other services to help your family become self-sufficient. Please contact the CITC office for referrals. For any additional needs you may have outside of services provided by CITC, please call 211 or visit their website at alaska211.org for additional resources.

    CHILD SUPPORT INFORMATION AND COOPERATION

    Alaska must collect child support and medical support from any parent who has the duty to pay support to a Tribal TANF recipient. This includes any money owed to you at the time you apply, as well as current and future child support payments.

    Any child support payments given or paid to you while receiving Tribal TANF must be reported and turned over to the CITC Tribal TANF office immediately. If you wish to change a child support order, you must obtain a new court order or get permission from the State of Alaska Child Support Services Division(CSSD).

    Note: While on TANF If you believe you have a good reason not to cooperate with CSSD, you must tell your eligibility technician or case manager immediately. You may be asked to provide information to support your reason.

    When you apply for Tribal Temporary Assistance you must:

    • Sign over to CITC Tribal TANF, your right to receive and keep child support payments due to you or to a child on Tribal TANF.
    • Cooperate with CSSD by providing information to establish paternity, help locate an absent parent, and enforce a child support obligation.
    • Non-cooperation with CSSD or failure to turn over to CITC payments received from CSSD can result in a penalty applied to the case, payee or caseclosure.

    AMERICANS WITH DISABILITIES ACT OF 1990

    Cook Inlet Tribal Council, Inc. complies with Title II of the Americans with Disabilities Act of 1990. If you have questions, contact the CITC Corporate Affairs Officer at (907) 793-3407. Financial Assistance Department does not provide medication management and does not provide a designated room for medication monitoring.

    SOCIAL SECURITY NUMBERS

    You must provide or apply for a social security number for yourself and each household members for whom you are seeking assistance from CITC Tribal TANF (42 CFR 435.910). CITC will use social security numbers to access information from the Social Security Administration datasystem.

    SPENDING POLICIES FOR TANF/GA SERVICES:

    Under Federal Law (section 4004(c) of P.L. 112-96) it is illegal to make purchases with or to access cash assistance on EBT cards/gift cards at any bars, liquor stores, marijuana stores, gambling or adult entertainment establishments. If you fail to abide to this policy a payee may be required.

    I certify that I have read and understand the entirety of this document

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  • Statement of Truth

  • Under penalty of perjury or unsworn falsification, I certify and acknowledge that the statements made on the application and during my interview for assistance regarding the persons in my home, income, resources, property, and all other items that pertain to my possible eligibility for benefits are true and correct to the best of my knowledge. I have read (or had read to me) my rights and responsibilities as descripted in the “Your Rights and Responsibilities” document.

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