First Baptist Church of Sutherland Springs

Assistance Policy
Effective April 1, 2018

The assistance request form may be utilized for benevolence or for requests related to supporting the victims or
families affected by the November 5, 2017 shooting incident.

Benevolence Guidelines:
1. Benevolence requests are for the necessities of life and may include, but are not limited to, utility bills,
rent/mortgage, medicines, food and transportation. No benevolence will be administered to relieve the
consequences of sin, such as bail bonds, drug/alcohol related issues, etc.
2. An applicant must complete the Assistance form and will normally be limited to receive assistance only
twice in any given calendar year.
3. Except in extenuating circumstances, payment of expenses will be made directly the provider.
Payment will typically be made by check or credit card. Evidence of the need such as copies of bills,
cutoff/eviction notices, prescriptions for medications, etc. must be provided and attached to the
application.
4. Applications will be reviewed and must be approved by the pastor and at least one deacon or church
trustee.
5. IRS requirements related to church employees and benevelonce will be adhered to.
6. Applications and information they contain will be held in strict confidence by all parties. Failure to
maintain this confidentiality may result in the removal from the benenevolence review committee
and/or denial of future aid to the applicant.

Restoration Committee (Victim Assistance) Guidelines:

1. The Restoration Committee is responsible for administering programs related to Victim Assistance
resulting from the November 5, 2017 shooting incident. Requests are limited to the assistance of
victims or family members of victims. Payment will be made from funds received and designated for
victim relief. If the funds are exhausted, standard benevolence guidelines will apply.
2. Assistance requests may be made for a wide variety of reasons, similar to the benevolence requests
above, but may also include items such as medical equipment, medical supplies, legal fees, or housing
modifications to assist with mobility impared family members.
3. Multiple applications may be received in a calendar year.
4. Payment of expenses may be made directly the provider or may be made to the applicant for
distribution to providers. Payment will typically be made by check. Evidence of the amount required to
meet needs such as copies of bills, prescriptions for medications, etc. must be provided.
5. If approved, applications for recurring items such as rent/mortgage, utility bills, medicines will be valid
for a 3 month period.
6. Applications will be reviewed by members of the Restoration Committee and must be approved by at
least two members of the Committee.
7. Applications and information they contain will be held in strict confidence by all parties.

Hold Harmless / Liability Release

First Baptist Church of Sutherland Springs, Texas, its Pastor, Officers, Agents, Employees and Members are
hereby released, forever discharged and held harmless from any and all liability, claims or demands for
personal injury, sickness or death, as well as property damage and expenses of any nature whatsoever which
may be incurred as a result of the review, approval, payment and/or denial of benefits under the
administration of the Benevolence or Victim Assistance programs. Furthermore, the requestor hereby agrees
to hold harmless and indemnify said Church, its Pastor, Officers, Agents, Employees and Members from any
financial liability sustained by said acts of the aforementioned church parties.
 First Baptist Church of Sutherland Springs
Assistance Request

Name of Applicant

Application Date

Current Address

Mailing Address,
(if different)

Phone Number

Email Address

Household Members Relationship Age Employment Status

Type of Assistance Requested Amount Requested For How Long?

Is this assistance request related to victims affected by the November 5, 2017 shooting incident? Yes No

Have you Received funds or assistance from other sources in the last six months? Yes No

If Yes, Please List where assistance is/was received from Approx Amount Received

I have read and understand the policies and guidelines for assistance receipt from the First Baptist Church of Sutherland Spings. My
signature constitutes my understanding and agreement to abide by them.

Applicant Signature Date Approved? Yes No

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