Family

Supplemental Income Application

The surviving spouse of clergy may be eligible to apply for need-based Supplemental Income. Grants are intended to help provide an adequate margin for fixed income expenses such as housing, utilitiies, insurance and medical care. The process begins with an application submitted in February for grants determined in March and distributed quarterly beginning in April.  Funds may be available at other times of year. Please contact the chaplain at chaplain@clergyassurancefund.org 

Contact Information

Financial Obligations & Expenses

Number of children living with you:
Number of other family members living with you:

Housing Status

Housing Costs

Medical Costs:

Other Regular Expenses (Specify):

Financial Resources & Income

Invested Funds: Approximate value of

Employment status:

Income from employment:

Income from other sources:

Other Sources (Specify)