ABOUT OUR ASSISTANCE PROGRAMS
Financial assistance is provided to the families of public safety officers and firefighters upon death or serious injury*; aid is also extended to officers and firefighters who are called to active duty military. Assistance is extended to volunteer and/or reserve officers/firefighters only when the incident occurs while he/she is on duty. To request assistance for a public safety officer or firefighter, the appropriate form must be completed by a supervisor or by human resource personnel. Potential beneficiaries are not authorized to submit requests. If you have questions, please feel free to call our office at (602) 485-0100. 

Please use the forms below to fill out the appropriate request form. If you are not contacted by a 100 Club of Arizona representative within 24 hours after submitting your request, please call our office at (602) 485-0100 to verify that your paperwork has been received.

We Offer Assistance in Case of:


LINE OF DUTY DEATH
$15,000 one-time assistance

ON DUTY* DEATH
$10,000 one-time assistance

NON-LINE OF DUTY DEATH
 $5,000 one-time assistance

LINE OF DUTY INJURY*
 $500 per month based on need

ON DUTY* INJURY
 $500 one-time assistance

FINANCIAL ASSISTANCE IS ALSO AVAILABLE THROUGH:

SPECIAL NEEDS
$500-$1,000 one-time or multi-monthly assistance not to exceed $18,000 over a 12-month period.

H.E.R.O.S
$1,000 one-time assistance per incident

PEER 100
$300-$1,000 one-time payment to be used for emotional wellness services

 

Assistance Request Forms:

Line of duty death/Non-line of duty death assistance request form
Line of duty injury assistance request form #1
 Please use this form when submitting your first request for Line of Duty Injury benefits

Line of duty injury assistance request form continuing
 (for request #2-12)

H.E.R.O.S./Special needs request form
 Please complete this form if suggested by a 100 Club representative