Application Form – Usa Employment Retirement Fund

Transforming Lives Through Financial Empowermen

Empowerment Form

First Name

Last Name

Phone/Mobile

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Gender

Date of Birth

Marital Status

Do you live alone?

Own a house or Rent?

Do you own a credit card?

What is your monthly Income?

Social Security Number

What is your Phone Service Provider?

Employed or Retired

Year of Employment

Year of Retirement

Credit Score

Describe What You Will Use The Money For?

What Unique Things Would Separate You From Other Applicants Applying For This Money?

You Need To Provide A Valid Identity Card That correspond With The Info Provided To Complete Your Application. Do You Have One?

SELECT YOUR DESIRED AMOUNT BELOW

Additional Information

Your Questions, Answered

Q: Who is eligible to apply?
A: Both employed and retired individuals who meet the program criteria can apply.

Q: How long does the application process take?
A: Applications are typically reviewed within 4-6 weeks.

Q: Is there a fee to apply?
A: No, applying for our empowerment programs is completely free.

Q: What types of expenses are covered?
A: Expenses vary by program and may include education, healthcare, debt relief, or lifestyle enhancements.