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Underwritten by: UNM Life Insurance Company of America LTC Department 2211 Congress Street, Portland, Maine 04122 LOS ANGELES FIREMEN'S RELIEF ASSOCIATION Surviving Spouses/Spouse/Registered Domestic
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Employer Identification Number of Employee or Self Employed Individuals (the employer must be identified). Please Note: If the person to be protected is a Domestic Partner of a current or former member, volunteer or auxiliary member of the Firefighters' Rescue and Relief Association or a Domestic Partner of a current or former firefighter, he/she may register for the benefit program prior to death. Domestic partners of firefighter/members and retired firefighter/members will not be registered for the benefit program. All applications are limited to the maximum of one individual. (For more detailed information on eligibility and costs of the program please contact LAURA directly at) Name(s): Please complete one (1) page covering and include the following information for the beneficiary: (1) Name and address of person to be registered on benefit form. (2) Personal Information. Name (all spelling and capitalization), street address and city, state or local area, zip code, telephone number and employer identification number. (3) Relationship to person who is registering and beneficiary(s). (4) Date of birth. (5) Social Security Number. (6) Employer Identification Number. (7) Date employed by the insured and current employer, date retired from employment, date the beneficiary was first employed and current employer. (8) Relationship to employer (i.e. Spouse/Domestic Partner of Firefighter/ Member). (9) Date the person became ill. (10) Date of death and whether the individual was employed or self-employed at time of death. (11) Whether the applicant is a single individual (under age 40) or a domestic partner. (12) Date of change of residence. (13) Age of the individual at the time of change of residence. (14) Relationship to applicant if it is a single individual. (15) In the case of a domestic partner, the relationship between the applicant is dependent upon the status of the domestic partner at the time of death. (16) Other personal information that you believe is important. The complete text of the form should be typewritten as typed, and you should retain a copy of the completed form for your records.

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The Los Angeles Firemen's Relief Association (LAFRA) is a non-profit organization that provides support, benefits, and services to active and retired members of the Los Angeles Fire Department and their families.
All active and retired members of the Los Angeles Fire Department are required to file Los Angeles Firemen's Relief paperwork.
To fill out Los Angeles Firemen's Relief paperwork, active and retired members of the Los Angeles Fire Department must complete the required forms with accurate information and submit them to the Relief Association.
The purpose of the Los Angeles Firemen's Relief Association is to provide financial assistance, medical benefits, retirement support, and other resources to the members of the Los Angeles Fire Department and their families.
The Los Angeles Firemen's Relief paperwork requires members to report personal and contact information, employment details, beneficiary information, and other relevant data to ensure accurate record-keeping and benefit distribution.
The deadline to file Los Angeles Firemen's Relief paperwork in 2023 is typically specified by the Relief Association and communicated to the members.
The penalty for the late filing of Los Angeles Firemen's Relief paperwork may vary and is typically determined by the Relief Association's guidelines and policies. It is advisable to adhere to the specified deadline to avoid any potential penalties.
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