441—58.53 (83GA,HF64) Application for assistance. To request financial assistance for unmet disaster needs expenses, the household shall complete Form 470-4689, Iowa Unmet Needs Disaster Grant Application, and submit the application to the local long-term recovery committee.
	 58.53(1) Application forms are available from the local long-term recovery committee or the rebuild Iowa office. Individuals can find their local long-term recovery committee by calling the rebuild Iowa office toll-free at (866)849-0323.
	 58.53(2) The application shall include:
	  a.   	 A declaration of the household’s annual gross income.
	  b.   	 A release of confidential information to personnel involved in administering the program.
	  c.   	 An assurance that the household had no insurance coverage for claimed items.
	  d.   	 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 other state assistance, local community development groups, charities or faith-based agencies, the Small Business Administration, or the Federal Emergency Management Administration.
	  e.   	 A short, written narrative of the disaster event and how the disaster caused the loss being claimed.
	  f.   	 A copy of a photo identification document for each adult applicant.
	  g.   	 When vehicle damage is claimed, current copies of the vehicle registration and liability insurance card.
[ARC 7603B, IAB 3/11/09, effective 2/11/09; ARC 8007B, IAB 7/29/09, effective 9/2/09]