> One Time Death Benefit Application
> Claim for Annuities for Dependents of Deceased Firefighters
> Affidavit (Annual)
> Direct Deposit Authorization
> W-9 Payer's Request for Taxpayer Identification Number and Certification
> Change of Address Form
> Death of Widow or Dependent Form
Checklist of items to include with your application for benefits:
- Death Certificate (if applicable)
- Letter from Fire Department stating dates of service
- Copies of Birth Certificates for Dependent Children (if applicable)
- Form W-9
- Direct Deposit Application
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Forms must be completed by the following dates:
Fall Seminster: June 30
Winter Session: September 30
Spring Semister: October 30
Summer Session I: March 31
Summer Session II: April 30
> Request for Tuiton Reimbursement
> Transcript Requests:
First time applicants must also include:
- A copy of their Birth Certificate
- A Letter from the Fire Department stating dates of service of their parent
* Please attach the transcript confirmation to the application for the final grade for seminster attending and mail to:
Relief of Injured and Deceased Police and Fire Fighters
Rhode Island Department of Labor and Training
1511 Pontiac Avenue, Building 73-2
Cranston, RI 02920
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