Applicant Information
Address and Contact
Employment Information
1st additional member
2nd additional member

Financial Information

Monthly Gross Income
Monthly Expenses
Financial Assistance Request
Terms of Application
Applicant accepts and testifies to the following:

1. MIA Takaful Fund Committee has permission to verify information provided by the applicant from appropriate sources.
2. Applicant has provided true and complete information to the best of his/her knowledge and may be disqualified for assistance if he/she knowingly provides false information on the application.
3. Applicant will be required to present all supporting documents, CRA filings, and/or letter of "Future Planning" upon request.
4. Applicant will not submit original bills or documents (Only photo copies please).
5. Application is accompanied by a copy of applicant's driver's license or other photo ID with current address and Manitoba Health Card. Incomplete applications may be declined or deferred.
6. MIA Takaful Fund Committee will put forth its greatest efforts to provide the best possible assistance based on individual's circumstances. Interfering factors include Zakah regulatory constraints, limited or unavailable funds. The decision made by the Takaful Committee will be final and it will not be provided in writing.
7. The requested assistance will be in the form of Takaful cheque, food certificates, counseling, and/ or referrals to government funded programs depending upon applicant's circumstances.
8. Applicant is responsible for reporting Takaful assistance to the CRA and other government agencies.
9. The Takaful Fund Committee may take up to 15 business days for processing and approval. (may take longer)
10. This application is valid for six months only, after which applicant may reapply if hardships persist.
11. All information and documents provided will be kept in the records for as long as the MIA Takaful Fund Committee see necessary.
12. Applicant acknowledges that he/she stands before Allah (SWT) in truth and Allah (SWT) is his/her witness.
Document Uploads

Clear photo or scan of your driver's license. (Maximum size is 5MB)


Clear photo or scan of your Manitoba Health Card (Maximum size is 5MB)

"O you who believe! Fear Allah (SWT) and be with those who are true (in words and deeds)." (9:119)

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