#VirtualMosque
About
About the MIA
Election & Compliance Commission
Volunteer Committees
Services
MIA Converts Committee
Mosques
MIA Facility Rental
Financial Assistance (Takaful)
Funeral Services (Janazah)
Marriage
Mental Health & Wellness
Religious Affairs
MIA Fiqh Committee
Prayer Locations
Iqama & Athan Times
Education
Educational Programs
Muslim Kids TV
Request Books for schools/libraries
Share the Prophet’s Message
Funeral Facility
Contact
Mailing List Signup
Become a Member
Volunteer
Donate
#VirtualMosque
About
About the MIA
Election & Compliance Commission
Volunteer Committees
Services
MIA Converts Committee
Mosques
MIA Facility Rental
Financial Assistance (Takaful)
Funeral Services (Janazah)
Marriage
Mental Health & Wellness
Religious Affairs
MIA Fiqh Committee
Prayer Locations
Iqama & Athan Times
Education
Educational Programs
Muslim Kids TV
Request Books for schools/libraries
Share the Prophet’s Message
Funeral Facility
Contact
Mailing List Signup
Become a Member
Volunteer
Donate
Financial Assistance (Takaful) Application Form
Click here for printable PDF form instead
Please enable JavaScript in your browser to complete this form.
Applicant Information
-
Step
1
of 6
Applicant Information
Name
*
First
Last
SIN
*
9 digits
Date of Birth
*
Legal Status
*
Citizen
PR
Other
Describe Legal Status
*
Marital Status
*
Next
Personal Information
Phone (cell/home)
*
Email
*
Email
Confirm Email
Home Address
*
Previous
Next
Employment information
Name of Company
*
Job Title
*
Company Address
*
Previous
Next
Supporting Documents
Please upload the following documents below, if applicable:
Copy of a photo ID
Last 3 paystubs (if employed)
Bank Statement (last 3 months)
Copy of Health Card
Copy of Rental/lease agreement
Letter of Explanation (Please write to us in detail, explaining your current situation and financial needs.Please specify the reason(s) you are seeking financial assistance through the Takaful program).
Information on other sources of income
Documented proof of need for special/extraordinary support (e.g., disability, medical)
File Upload
Click or drag files to this area to upload.
You can upload up to 12 files.
Amount of Financial Assistance Requested
*
Previous
Next
References
Reference 1 Name
*
Reference 1 Phone
*
Reference 2 Name
Reference 2 Phone
Previous
Next
Applicant accepts and testifies to the following: (Please read carefully before signing)
MIA Takaful Fund Committee has permission to verify information provided by the applicant from appropriate sources.
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.
Applicant will be required to present all supporting documents, CRA filings, and/or letter of "Future Planning" upon request.
Applicant will not submit original bills or documents (Only photo copies please).
Application is accompanied by a copy of applicant's driver's license or other photo ID with current address. Incomplete applications may be declined or deferred.
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.
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.
Applicant is responsible for reporting Takaful assistance to the CRA and other government agencies.
The Takaful Fund Committee may take up to 15 business days for processing and approval. (may take longer)
This application is valid for six months only, after which applicant may reapply if hardships persist.
All information and documents provided will be kept in the records for as long as the MIA Takaful Fund Committee deems necessary.
Applicant acknowledges that he/she stands before Allah (SWT) in truth and Allah (SWT) is his/her witness.
Confirmation
*
I accept and testify to the above
Date
Phone
Submit