Send questions to: GeneralWelfare@PuyallupTribe-nsn.gov

I am an enrolled Member eligible for assistance under the adult Puyallup Tribe of Indians General Welfare Assistance Program hereby confirm that I understand that benefits under the Program are limited to those that fit within the specific purposes described in EXHIBIT A. I have applied my monthly and any other general welfare assistance payments solely for one or more of the following qualifying expenses during calendar year 2022 (please fill in the dollar amounts):

I certify that the above information is true and correct, that I will use or have used my Assistance for the above purpose, that the expenditure was reasonable in amount, and that the benefits applied are consistent with Tribal goals and Program purposes to promote the general welfare. I understand that it is my responsibility to retain adequate records if necessary to prove the amount of my expenses as described in EXHIBIT A. I understand that if I am not able to substantiate qualifying expenses at least equal to the general welfare benefits I received during the year, that the Tribe must report these benefits as taxable.

The following expenditures are based in part on Revenue Procedure 2014-35, the Puyallup Tribe of Indians General Welfare Ordinance and related program descriptions, and Internal Revenue Code Section 139E:

Assistance relating to principal residences and ancillary structures that are not used in any trade or business or for investment purposes, for: (A) Mortgage payments, down payments or rent payments (including but not limited to security deposits) for principal residences; (B) Enhancing habitability of housing, such as be remedying water, sewage, sanitation services, safety (including but not limited to mold remediation), or heating or cooling issues; (C) Providing basic housing repairs or rehabilitation (including but not limited to roof repair and replacement); (D) Paying utility bills and charges (including but not limited to water, electricity, and gas, and basic communication services such as phone, internet, and cable).

(A) Provide students (including but not limited to post-secondary students) transportation to and from school, tutors, and supplies (including but not limited to clothing, backpacks, laptop computers, musical instruments, and sports equipment) for use in school activities and extracurricular activities; (B) Provide tuition payments for students (including but not limited to allowances for room and board on or off campus for the student, Spouse, Domestic Partner, and Dependents) to attend preschool, school, college or university, online school, educational seminars, vocational education, technical education, adult education, continuing education, and alternative education; (C) Provide for the care of children away from their homes to help their parents or other relatives responsible for their care to be gainfully employed or to pursue education; (D) Provide job counseling and programs for which the primary objective is job placement or training, including but not limited to allowances for: (1) Expenses for interviewing or training away from home (including but not limited to travel, auto expenses, lodging, and food); (2) Tutoring; and (3) Appropriate clothing for a job interview or training (including but not limited to an interview suit or a uniform required during a period of training).

(A) Meals through home-delivered meals programs or at a community center or similar facility; (B) Home care such as assistance with preparing meals or doing chores, or day care outside the home; (C) Local transportation assistance; (D) Improvements to adapt housing to special needs (including but not limited to grab bars and ramps).

(A) Pay transportation costs such as rental cars, substantiated mileage, and fares for bus, taxi, or public transportation fares between an Indian reservation, service area or service unit area and facilities that provide essential services to the public (such as medical facilities and grocery stores); (B) Pay for the cost of transportation, temporary meals, and lodging while the individual is receiving medical care away from home; (C) Pay for individuals in exigent circumstances (including but not limited to victims of abuse), including but not limited to the cost of food, clothing, shelter, transportation, auto repair bills, and similar expenses; (D) Pay costs for temporary relocation and shelter for individuals involuntarily displaced from their homes (including but not limited to situations in which a home is destroyed by a fire or a natural disaster); (E) Provide assistance for transportation emergencies (for example, when stranded away from home) in the form of transportation costs, a hotel room, and meals; (F) Pay the cost of nonprescription drugs (including but not limited to traditional Indian tribal medicines).

(A) Pay expenses (including but not limited to admission fees, transportation, food, and lodging) to attend or participate in an Indian tribe’s cultural, social, religious, or community activities, such as pow-wows, ceremonies, and traditional dances; (B) Pay expenses (including but not limited to admission fees, transportation, food, and lodging) to visit sites that are culturally or historically significant for the tribe, including but not limited to other Indian reservations; (C) Pay the costs of receiving instruction about an Indian tribe’s culture, history, and traditions (including but not limited to traditional language, music, and dances); (D) Pay funeral and burial expenses and expenses of hosting or attending wakes, funerals, burials, or other bereavement events, and subsequent honoring events; (E) Pay transportation costs and admission fees to attend educational, social, or cultural programs offered or supported by the Tribe or another tribe.

Non-lavish or Non-extravagant expenses for food and clothing.

(A) One car payment (B) Insurance (care and home) (C) Family gatherings and outings (D) other reasonable household expenses