Request Assistance

Minimum Requirements:

Provide details on Request Assistance Page
Member 2 or member 4 DD214 must be submitted for DOF Board review (for enhanced security purposes, please remove or cover up any confidential or sensitive information, including social security number, etc)
Must be Honorable Discharged
Must have been deployed overseas with boots on ground in a combat zone
Provide brief description of support being requested
Provide supporting current documentation for rent, lease, utility, auto and other emergency events

Full Name * {{::$ctrl.errors.full_name}}

Email Address * {{::$ctrl.errors.email}}

Phone * (10-digit) {{::$ctrl.errors.phone}}

Address Street 1 * {{::$ctrl.errors.address_1}}

Street 2 {{::$ctrl.errors.address_2}}

City * {{::$ctrl.errors.city}}

State * {{::$ctrl.errors.state}}

Zip Code * {{::$ctrl.errors.zip}}

Branch of Service * {{::$ctrl.errors.branch_of_service}}

Injury/Disability {{::$ctrl.errors.disability}}

Injury/Disability VA Rating {{::$ctrl.errors.va_rating}}

Monthly Income * {{::$ctrl.errors.monthly_income}}

Income Source * {{::$ctrl.errors.income_source}}

DD214-Member 4 (PDF) * {{::$ctrl.errors.dd214_file}}

Other Relevant Documents (PDF) (max: 4) {{::$ctrl.errors.relevant_documents}}