Apply for Assistance

Notice: We are currently unable to process applications. We expect to begin in early 2026.

Complete the below application to request assistance for the funeral expense of a deceased Muslim.

Instructions:

Complete all sections and attach supporting documents.
The board will review per Funeral Assistance Policy.
Funds disbursed preferably directly to the funeral service provider.
Current maximum assistance amount: $8,000

Upon submission, your application will be reviewed and you will receive a response within 24-48 hours.

A - Applicant Information

First Name

Relationship to Deceased

Last Name

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

B - Deceased Information

Deceased First Name

Deceased Last Name

Date of Birth

Date of Death

Gender

Male

Female

Are they Muslim?

Yes

C - Funeral Details

Funeral Home/Masjid

Contact Person

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

D - Assistance Requested

Total Funeral Cost ($)

Amount Requested ($)

Who will payment be made to? Note: Direct payments to funeral home preferred

Funeral Home

Masjid

Family

Other

if "Other", please specify

E - Supporting Documents

Please Upload:

1. Death certificate or verification from funeral home/masjid

Death certificates are issued by the department of vital records

2. Invoice or estimate from funeral service provider

This must include details of the funeral home issuing the invoice

3. Proof of Muslim identity

This may simply be a signed statement from an Imam or community member

Death Certificate

Upload File

File Types: .PDF, .PNG (Max 15MB)

Invoice

Upload File

File Types: .PDF, .PNG (Max 15MB)

Proof of Muslim Identitiy

Upload File

File Types: .PDF, .PNG (Max 15MB)

Note: for urgent requests where all documentation is not yet available, you may upload the invoice to all fields and provide the remaining documents within 90 days.

Attestation & Submission

I attest to the accuracy of the information provided.

Your Signature