1. Section Completed by Company/Battery Commander or First Sergeant
FMWR Army Community Service/Financial Readiness Program
Toys for Kids 2018
Financial Assessment and Referral Form for Service Members E5 and above
Submit Form and Supporting Documents* to ACS Financial Readiness Program
BLDG 4700
Date: ______________________
Full Name (Print): ________________________________________________Rank:________
Brigade: _____________ Battalion: _________ Unit:__________________
Name of Commander or 1SG_____________________________________________________
Spouse’s Name: _______________________________________________________________
Home Address: _______________________________________________________________
Phone Number: _________________Number of Children in the Home: ___________________
Section Completed by Company/Battery Commander or First Sergeant
Section Completed by Financial Readiness Program Staff
Describe the Service Member’s financial hardship:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Is military family participating in any other holiday program? Yes/no __________________
Military Family’s Budget (Attach Budget)
Monthly Gross Income: ______________ Monthly Surplus or (Deficit): _______________
Monthly Net Income: _______________
Monthly Expenses: _______________
FRP Staff Member Reviewing Request:________________________________________________
Recommend Approval/Disapproval (circle one)
FRP Program Manager Final approval:________________________________________
* SM will need to bring the following documents to the appointment with FRP staff member: current LES, past due bills, financial summaries and any document that supports the financial hardship. SM will participate in a financial session to review current situation and future financial planning.