COVID-19 Emergency Financial Relief Grant Verification

REMINDER: MOAA will NOT ask you to provide your Social Security number or bank information over the phone or in response to an email. DO NOT provide this information unless asked for through a secure link via an email from A MOAA staff member will only ask for this information and provide you a secure link to send if you are being awarded a grant, and the request will come directly from Please email or call the MOAA Member Service Center at (800) 234-6622 if you feel uncomfortable about a request and would like to verify authenticity.   


(Form last updated March 8, 2021; for questions about this application, please contact MOAA's Member Service Center at 800- 234-6622 or e-mail


Thank you for taking time to help The MOAA Foundation verify an applicant for the COVID-19 Emergency Financial Relief Grant. Please complete and submit the Council/Chapter Verification Form.


If the individual you are assisting is awarded a grant, funds will be disbursed to them pending submission of verification information requested in their award email. If they have not provided required documentation as requested within 30 days of the foundation sending their award email, their grant award offer will expire, and they will need to submit a new application for consideration.


Verification Form Option: If you would prefer to use a fillable PDF/printer-friendly version, learn more and download.


Council/Chapter Verification Form