605—11.3(29C) Application for assistance. To request assistance for disaster-related expenses, the household shall complete Form 470-4448 and submit it within 45 days of the disaster declaration to the contracted administrative entity.
	11.3(1) Application forms are available from an approved administrative entity, as well as the Internet website of the department at www.homelandsecurity.iowa.gov.
	11.3(2) The application shall include:
	a. 	A declaration of the household’s annual income, accompanied by a current pay stub, W-2 form, or income tax return.
	b. 	An authorization to release confidential information to personnel involved in administering the program.
	c. 	A certification of the accuracy of the information provided.
	d. 	An assurance that the household had no insurance coverage for claimed items.
	e. 	A commitment to refund any part of a grant awarded that is duplicated by insurance or by any other assistance program, such as but not limited to local community development groups and charities, the Small Business Administration, or the Federal Emergency Management Administration.
	f. 	A short, handwritten narrative of how the disaster event caused the claimed loss, including an itemized list of items damaged by the disaster.
	g. 	A copy of a picture identification document for the adult applicant.
	h. 	When vehicle damage is claimed, current copies of the vehicle registration and liability insurance card.
	11.3(3) The application period may be extended beyond 45 days through an extension of the governor’s disaster proclamation. If the forty-fifth day falls on a Saturday, Sunday, or holiday, the deadline is moved to the following business day.
[ARC 9128B, IAB 10/6/10, effective 10/1/10; ARC 9312B, IAB 12/29/10, effective 3/1/11; ARC 1353C, IAB 3/5/14, effective 5/1/14; ARC 6850C, IAB 2/8/23, effective 4/1/23; Editorial change: IAC Supplement 6/28/23]