Online Basic Living Assistance Payment for Minors

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This field is for validation purposes and should be left unchanged.

This form is being provided for a parent or legal guardian to accept a minor tribal member's November 2026 Basic Living Assistance Payment. It applies to the November 2026 Basic Living Assistance payment. If a parent or legal guardian does not submit an application for a minor tribal member, the payment will be made to the Minor's trust account. If a parent or legal guardian has multiple children, they can all be listed on one application where one payment will be made. Only the legal custodial parent or legal guardian can provide an application on behalf of a child.

MINOR #1

TRIBAL ROLL NUMBER(Required)

MINOR #2

TRIBAL ROLL NUMBER

MINOR #3

TRIBAL ROLL NUMBER

MINOR #4

TRIBAL ROLL NUMBER

MINOR #5

TRIBAL ROLL NUMBER

MINOR #6

TRIBAL ROLL NUMBER

MINOR #7

TRIBAL ROLL NUMBER

MINOR #8

TRIBAL ROLL NUMBER

MINOR #9

TRIBAL ROLL NUMBER

PARENT/GUARDIAN/PAYEE INFORMATION:

TRIBAL ROLL NUMBER

EMAIL(Required)

Any errors or omissions may delay any processing. All records above will be verified against the enrollment database.
If you would like direct deposit, a separate form needs to be turned into CTSI Accounting by October 23, 2026.
If a child is claimed by more than one adult, more documentation or evidence may be required prior to disbursement. The Trust Officer's decision on payment is final and not available for appeal.
If you are not in the Tribe's vendor system, you will be required to complete a W-9 form prior to payment.

W9

Upload an image or pdf of your W9 here if necessary.

Max. file size: 100 MB.

SIGN & SUBMIT

DATE(Required)

BASIC LIVING ASSISTANCE PAYMENT FOR MINORS

MINOR #1

MINOR #2

MINOR #3

MINOR #4

MINOR #5

MINOR #6

MINOR #7

MINOR #8

MINOR #9

PARENT/GUARDIAN/PAYEE INFORMATION:

SIGN & SUBMIT

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