Funds Application Form

FORM GUIDANCE

Before starting this form you should be aware you will be held accountable for all the information provided within this form. Any intentionally incorrect, false or misleading information, the Nawaal Fund may seek legal advice to report you for fraud.

Criteria Area: Please note; we only accept applications from within the Central London boundary of the North Circular and South Circular Roads. Applications received from outside this London boundary will not be accepted

Filling in this form

To allow your form to be processed in a timely manner please ensure ALL the information provided in this form is accurate and as detailed as possible. Your full financial situation must be given. Forms submitted with incomplete information may result in your application being delay or rejected. Simply applying for funds does NOT mean automatic approval of your application. For help completing this form please email cases@nawaal.org.

What to submit

You MUST provide clear photocopies of ALL the following documents with your application (if applicable)

Your photo ID (this must be a passport, driving licence or any similar official government issued ID)
ID for all dependents mentioned within this form (copies of passport or birth certificates)
Rental, tenancy or mortgage agreement
Council tax
Benefit payments (includes child benefit, child or working tax credit, job seekers allowance, disability allowance, housing and council tax benefits, child maintenance payments, universal credits or any other form of benefit or credits)
Proof of income (your most recent payslip)
Bank statement (most recent)
Utility bills (most recent)
Documented/written proof of debts
Other documents/s that outline your financial or immigration status All documents once submitted become the property of the Nawaal Fund and will therefore NOT be returned to you (please do NOT submit originals).

Application process & decision

The Nawaal Fund will examine your application and contact the two references to verify your information.

Whilst processing your application the Nawaal Fund may contact, in confidence, other organisations or individuals it sees fit in order to help reach a decision on your application.

The approximate processing time for applications is 10 workings days. This may be extended if the Nawaal Fund needs further information to help reach a decision.

If your application is successful you may not necessarily receive the full amount requested. Any funds paid may include payment by means of supermarket vouchers or similar forms of acceptable means of exchange for goods and services, payment directly to your landlord or payment directly to your creditors.

Before starting this form you should be aware you will be accountable to Allah on the day of judgement for all the information provided within this form, incorrect, false or misleading information will have an impact in this worldnand the hereafter.

Step 1 of 2

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Section 1 - Personal Details
Full Name:
Sex:
Address & How long you have lived here: (if you have lived at this address for less than 12 months what made you move here)
Do you live alone or share House/Flat with others:
Age:
Religion:
- Sunni
- Shi'a
- Other (Please mention):
Other Religion:
National Insurance Number: (if applicable)
Marital Status:
Health/Disability:
Employment Status:
Mobile
Phone
Home
Email
Descendent of the Prophet (SAW): (Are you a descendent of the Prophet (SAW) i.e. are you a ‘Syed’ )
Immigration/ Nationality Status:
Previous Reference Number/s: (If you have applied to the Nawaal Fund for assistance before please provide the application reference and date you applied)
Section 2 - Dependent Details
Provide the names of any children or dependents living with you who financially depend on you for their needs. Full name, ages and whether each of the dependents are babies/toddlers, at school, work/unemployed, retired etc.
Section 3 - Personal Statement
Amount of funds requested (£)
Provide a detailed statement outlining the reasons why you need financial assistance. The statement MUST also fully justify the amount of funds you are requesting by providing a detailed itemised breakdown of what the funds will be spent on. You MUST also explain how you are currently meeting your personal, family and other expenses. Attach any documents to this form that may support your statement. At the end of your statement please also state what endeavours, if any, you will be undertaking to improve your financial situation to help you become financially independent. (Continue on a separate paper if required)
How did you find out about the Nawaal Fund?
Section 4 - Saving & Assets
Cash in hand and in the Bank £:
Gold (in grams):
Silver (in grams):
Property
Stock & Shares (£):
Money owed to you (i.e. money you have lent to others, owed wages or back dates benefits etc) £:
Other (please mention):
Section 5 - Income
Provide full details of ALL income you have received over the past 6 months:
Job
Amount (£) Last Received Frequency
Job Seekers Allowance
Amount (£) Last Received Frequency
Income Support
Amount (£) Last Received Frequency
Child Tax Credits
Amount (£) Last Received Frequency
Working Tax Credits
Amount (£) Last Received Frequency
Child Benefit
Amount (£) Last Received Frequency
Pension
Amount (£) Last Received Frequency
Housing Benefit
Amount (£) Last Received Frequency
Council Tax Benefit
Amount (£) Last Received Frequency
Food Stamps/Vouchers
Amount (£) Last Received Frequency
Other i.e. Child Maintenance Payments, Maternity Pay, Universal credits, investments, stock/shares, rental income etc. (Please mention):
Amount (£) Last Received Frequency Description
Section 6 – Expenses
Provide full details of ALL your outgoing expenses:
Rent/Mortgage (please choose)
Amount (£) Last Paid Frequency
Council Tax
Amount (£) Last Paid Frequency
Food/Clothing
Amount (£) Last Paid Frequency
Utility Bills: Gas, Electric, Water, Phone, Internet, TV
Amount (£) Last Paid Frequency
School Fees
Amount (£) Last Paid Frequency
Transport/Fuel
Amount (£) Last Paid Frequency
Other i.e. child maintenance payments debts such as loans, rent/council tax arrears, etc. (Please mention):
Amount (£) Last Paid Frequency Description
Others
Amount (£) Last Paid Frequency Description
Section 7 – Loans and Debts
Please state all the debts and loans you currently have. This can be private loans (with friends or family) or debts with companies (such as credit cards, loan companies and debts with utility companies etc)'
Section 8 - Previous Assistance
Provide full details of any previous applications you have made for financial assistance to other organisations and charities:
Name of Organisation Funds/Assistance Received Date
Section 9 – References
Give the names of two individuals, preferably living in the Hackney, Haringey, Waltham Forrest or close-by area that can be contacted to verify the information you have provided in this application. References cannot be from relatives, those you live with or those mentioned within this form. At least one reference must be a Muslim and a professional (e.g. teacher, solicitor, GP, caseworker, Imam/scholar, etc.).
First Reference:
Full Name:
Address
Contact Number:
Email:
How do you know this person:
Second Reference:
Full Name:
Address:
Contact Number:
Email
How do you know this person:
Section 10 - Declaration & Testimony
I testify that the information provided on this form is true and accurate to the best of my knowledge. I agree that the information provided in this application will be utilised in connection with this request for funds from the Nawaal Fund. I also agree for the Nawaal Fund to make any necessary inquiries to verify the information provided in this form. I have provided ALL the necessary documents outlined in the 'What to submit' section and also fully understand and accept ALL the points mentioned in the 'Guidance Notes' on the front of this form. In order to meet my financial needs I agree for the Nawaal Benevolence Fund to spend zakah funds on my behalf if my application is successful.
IF APPLICATION COMPLETED BY SUPPORT WORKER / SOMEONE ELSE ON BEHALF OF NAMED APPLICANT
s
- I confirm I have read out the Section 10 Declaration & Testimony to the named applicant who this form is for and that they have confirmed their acceptance of the declaration & testimony.
Print Name of Person Completing Form (if not the named applicant)
Print Name:
Date
Date Format: MM slash DD slash YYYY
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Amount (£)	Last Received	Frequency	Description

Amount (£)	Last Paid	Frequency	Description

Name of Organisation	Funds/Assistance Received	Date

Nawaal Benevolence Fund

FORM GUIDANCE

Before starting this form you should be aware you will be held accountable for all the information provided within this form. Any intentionally incorrect, false or misleading information, the Nawaal Fund may seek legal advice to report you for fraud.

Filling in this form

What to submit

Application process & decision

Funds Application Form

Step 1 of 2

Section 1 - Personal Details

Section 2 - Dependent Details

Section 3 - Personal Statement

Section 4 - Saving & Assets

Section 5 - Income

Section 6 – Expenses

Section 7 – Loans and Debts

Section 8 - Previous Assistance

Section 9 – References

First Reference:

Second Reference:

Section 10 - Declaration & Testimony

IF APPLICATION COMPLETED BY SUPPORT WORKER / SOMEONE ELSE ON BEHALF OF NAMED APPLICANT

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