Hardship Assistance Application Form

Information about the employee, driver or independent contractor applying for hardship assistance.

Secondary Person we may contact regarding this application

The Foundation is not intended to be a substitute for insurance coverage. The Foundation cannot assist in all hardships. See the FAQ for other resources that can also assist during hardship situations.

If approved, payments will be made directly to vendors in the form of bill payments. Documentation/invoices will be required. The Foundation maximum disbursement is $5,000 per hardship.

Applications will be handled in a confidential manner. Applications will be reviewed with Company management. Additionally, non-identifying statistical information will be tracked for record keeping purposes. Applicants are expected to provide truthful, accurate, and complete information. Fraudulent or misleading applications will prevent the application from future use of the Anderson Assistance Foundation resources, and will be reported to Company management.