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About Siletz news / (Siletz, OR) 199?-current | View Entire Issue (Jan. 1, 2004)
TRIBAL PROGRAM NEWS Computer Requests Eligible Forms of Documentation Unacceptable forms of verification: Address Verification For tribal member applicants and applicants for non-tribal custodial parents addresses, the following types of documentation are acceptable: • • • • • • • • Telephone bill Water/sewer bill Cellular telephone bill Natural gas bill Garbage collection bill (regular weekly service) Property tax statement Monthly mortgage statement Formal rental agreements from outside parties or agencies • • • • Custody Verification For non-tribal custodial parents, the following types of documentation are acceptable. These verification(s) must accompany the application form. • • All documentation must be in the applicant’s name as it appears on the tribal roll and list the street address (not just mailing address) where service is provided. Notes, rental agreements, or letters from family, friends, or co habitants in the residence Medical bills Driver’s licenses Utility bills in someone else’s name • Divorce decree awarding custody to applicant parent Adoption or state/tribal welfare placement records awarding custody to applicant parent In the absence of either of the above, copies of birth certificates listing the tribal parent applicant Computer Application Request Form Deadline for applications is 4:30 p.m. on Jan. 15,2004. Households eligible to apply include: • • • The burden of proof is on the applicant. Applicant and previous recipient must provide verifica tion of their current residence. Any tribal household that has not previously received a computer Any non-tribal household that has custody of tribal children and has not previously received a computer Any household with duplicate addresses that can provide proof that the person/household that previously received a computer is no longer part of their household. —--------------------------------- ------------------------------------- ■ Non-Tribal Custodial Parent Application on Behalf of Enrolled Siletz Tribal Child(ren) Computer Application Request Form (One per household/address) Parent’s Name:_________________________________________________________ Enrolled Child(ren) Name(s):____________________________________________ (One per household/address) Applicant Name:_______________________________________________________ Roll #:___________________________ Social Security #:-------------------------- Street Address:_________________________________________________________ Mailing Address:_______________________________________________________ City/State/ZIP:_________________________________________________________ Telephone #:______________________ I am requesting a computer for my household. I understand that it is a taxable donation and that I am responsible for payment of any taxes due on the value of the computer. Signature:_____________________________________ Date:_______________ What level of computer knowledge does your household possess? None Basic Intermediate Advanced Would you need assistance to set up the computer? If yes, would the assistance be: in home No Yes by phone Would you require training to operate the computer? No Yes Please complete and return by 4:30 p.m. on Jan. 15, 2004. Please make sure you enclose verification of your physical address in the applicant’s name as it appears on the tribal rolls. Verification may include an electric bill, phone bill, other utility bill, or property tax statement that lists the applicant’s name and physical address. Applications without this verification or received after the deadline will not be considered. If you have any questions, please leave a message -at 541-444-8305 or 1-800-922-1399, ext. 305, and we will return your call. Do not fax your application. Original signatures are required. Return completed applications to Confederated Tribes of Siletz Indians of Oregon, Attn: Computer Applications, P.O. Box 549, Siletz, OR 97380-0549. Roll #:________________________________________________________________ Street Address:______ ___________________________________________________ Mailing Address:_______________ ______________________________________ _ City/State/ZIP:___________________ _____________________________________ Telephone #:Parent’s Soc. Security #: I am requesting a computer for my enrolled Siletz tribal child(ren). I understand that it is a taxable donation and that I am responsible for payment of any taxes due on the value of the computer. Date:_______________ Signature:------------------------------------------------------- What level of computer knowledge does your household possess? None Basic Intermediate Advanced Would you need assistance to set up the computer? If yes, would the assistance be: in home No Yes by phone Would you require training to operate the computer? No Yes Please complete and return by 4:30 p.m. on Jan. 15, 2004. Please make sure you enclose verification of your physical address in the applicant’s name. Verification may include an electric bill, phone bill, other utility bill, property tax statement, or other verification that lists the applicant’s name and physical address. Also, verification of custody of the applicant parent through birth certificates, divorce decrees, or other documentation granting custody to the parent applicant. Applications without this verification or received after the deadline, will not be considered. If you have any questions, please leave a message at 541-444-8305 or 1-800-922-1399, ext. 305, and we will return your call. Do not fax your application. Original signatures are required. Return completed applications to Confederated Tribes of Siletz Indians of Oregon, Attn: Computer Applications, P.O. Box 549, Siletz, OR 97380-0549. January 2004 □ Siletz News □ 9
