Navajo Nation Claim Form PDF Details

Navajo Nation Claim Form provides you with the opportunity to apply for Tribal and Federal benefits. This claim form is a critical part of applying for financial assistance, scholarships, educational grants or other programs sponsored by the Navajo Nation. The application process can sometimes feel overwhelming but understanding what information is needed and where to find it will help make completing your claim form easy. In this blog post, we'll walk through what documents are necessary to complete the Navajo Nation Claim Form as well as provide helpful tips on how to finding crucial information needed throughout the application process.

QuestionAnswer
Form NameNavajo Nation Claim Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnavajo nation omb budget forms, navajo nation general claim forms, navajo nation general claim form, navajo nation travel form insurance propose only

Form Preview Example

DATE OF CLAIM

THE NAVAJO NATION

FINANCIAL SERVICES DEPARTMENT

GENERAL CLAIM FORM

ACCOUNTS PAYABLE USE ONLY

AB#

CO#

 

 

NAME OF CLAIMANT

(PRINTED)

SOCIAL SECURITY NUMBER

MAILING ADDRESS

CITY

STATE

ZIP CODE

TYPE OF CLAIM

COUNCILMEN ONLY --- CHECK ONE OF THE FOLLOWING

BOARD OF ELECTION

LABOR COMMISSION HUMAN RIGHTS COMMISSION BLACK MESA REVIEW BOARD

NAVAJO UTAH COMMISSION

NNWATER RIGHTS COMMISSION NN BOARD OF EDUCATION NAVAJO/HOPI LAND COMMISSION COUNCILMEN SALARY ADVANCE

TELECOMMUNICATION REG. COM GOVERNMENT DEVELOPMENT

LOCAL (SEMI-MONTHLY) CHAPTER MEETING OTHER (SPECIFY)

ROUGH ROCK CHAPTER SHIPROCK CHAPTER FORT DEFIANCE CHAPTER COALMINE CHAPTER

 

CHAPTER OFFICERS ONLY – CHECK ONE OF THE FOLLOWING:

 

 

 

 

 

LOCAL CHAPTER MEETING

PLANNING MEETING

AGENCY MEETING

 

 

 

 

 

 

 

ALL OTHERS --- CHECK ONE OF THE FOLLOWING:

 

 

 

 

LAND (FARM) BOARD

DISTRICT GRAZING COMMITTEE

RETIREMENT PAYOUTS

 

EASTERN NAVAJO LAND BOARD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DESCRIPTION OF MEETING

LOCATION OF MEETING(S)

DATE(S)

PURPOSE OF MEETING OR ITEMS DISCUSSED

USE BACK IF NECESSARY

TRAVEL INVOLVED

FROM

TO

TO

TOTAL MILES

1.

2.

3.

 

 

 

AMOUNT OF CLAIM

 

 

CONTROLLER’S OFFICE USE ONLY

 

 

 

 

 

 

 

 

 

 

FUNDS

 

 

 

 

 

 

 

 

 

 

 

AVAILABLE

 

 

 

 

 

 

 

 

 

ACCOUNT NO.

 

BY

DATE

 

 

DAYS @ $

 

PER DIEM $

 

 

 

 

 

 

 

 

 

DAYS @ $

 

PER DIEM $

 

 

 

 

 

 

 

 

 

DAYS @ $

 

PER DIEM $

 

 

 

 

 

 

 

 

OTHER EXPENSES (ATTACH RECEIPTS)

 

 

 

 

 

 

 

ADVANCE REQUESTED

 

 

 

 

 

 

 

 

 

LESS DEDUCTIONS

 

 

(

)

 

 

 

 

 

 

 

 

TOTAL

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that this claim is true and just to the best of my knowledge and that the amounts claimed are due to me and have not been previously paid.

If approved, I request that the check be ready by (time) ____________ on (date) ____________.

I request that the check be (check one)

 

Mailed to me at the address

Picked up by myself

Picked up by person other than myself (name)

 

SIGNATURE OF CLAIMANT

CLAIM APPROVED BY: CHAIRMAN, N.T.C., COMMITTEE CHAIRMAN, CHAPTER PRES., ETC.

CONTROLLER’S APPROVAL

ADVANCES ONLY

 

CURRENT

ADVANCE RECORDED PAYROLL

SIGNATURE

DATE

SIGNATURE

 

 

DATE

ADVANCE BALANCE

BY

DATE

 

 

 

 

 

 

 

 

 

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Filling out part 1 in navajo nation general claim form

2. Once your current task is complete, take the next step – fill out all of these fields - AMOUNT OF CLAIM, CONTROLLERS OFFICE USE ONLY, DAYS, DAYS, DAYS, PER DIEM, PER DIEM, PER DIEM, OTHER EXPENSES ATTACH RECEIPTS, ADVANCE REQUESTED, LESS DEDUCTIONS, TOTAL, ACCOUNT NO, FUNDS, and AVAILABLE with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

navajo nation general claim form completion process described (stage 2)

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