LINE OF DUTY INJURY ASSISTANCE

The 100 Club of Nevada will consider providing assistance to any First Responder who suffers a catastrophic injury which may be life altering or career ending, on a case-by-case basis. Please contact us for more information.

LINE OF DUTY DEATH FINANCIAL ASSISTANCE

Financial assistance is provided to the designated beneficiary of a fallen First Responder who suffers a Line of Duty Death. This support encompasses all Law Enforcement, Fire Service, and Emergency Medical Service personnel, whether paid professional, reserve, or volunteer. It extends to all levels of government – municipal, county, state, tribal, and federal.

DEFINITIONS AND PROTOCOLS

Line Of Duty Death (LODD) Definition

LODD must be associated with attempts to save life or property, or enforce the law. Traffic accidents are covered while responding to an emergency, but no benefit will be offered for non-emergency traffic accidents. One exception to non-emergency traffic accidents is if the accident was caused by an equipment malfunction out of the control of the driver.
The following are not covered under LODD:
• Any death due to natural causes, disease, or routine non-emergency accidents that could happen in any workplace or while off duty.
• Any death that occurs off-duty or due to routine duties that are non-emergency and are similar to off-duty activities (e.g., eating, sleeping, exercising, non-emergency driving, etc.)

First Responder Definition

Firefighters, Law Enforcement Officers, EMS, those working under the auspices of incident command.

Geographic Reach

State of Nevada, including out-of-state responders providing emergency assistance within Nevada, and Nevada responders assigned to mutual aid assistance outside the state.

Protocol

The “Line of Duty Death Assistance Request” form must be completed by a supervisor or human resource official from the affected public safety agency. Potential beneficiaries are not authorized to submit requests directly. If you are not contacted by a representative of the 100 Club of Nevada within 24 hours, please call our office number to verify that your request has been received.

Click one of the buttons below to fill the form online or download a fillable pdf form.

LODD Request PDF Form

TO SUBMIT A LINE OF DUTY DEATH ASSISTANCE FORM ELECTRONICALLY, PLEASE SEE THE FORM BELOW

LINE OF DUTY DEATH MORTGAGE ASSISTANCE

Discover an exclusive complimentary benefit from CrossCountry Mortgage designed to honor and support our brave First Responders. In the event of tragedy, qualified borrowers from law enforcement, fire, or EMS who fall in the line of duty will find relief, as CrossCountry Mortgage cancels mortgage debt up to $525,000 for their surviving family members. This invaluable support is a testament to our commitment to the heroes who serve our communities selflessly. Plus, if you’re a First Responder in Nevada, we’re here to assist you with loans tailored to your needs. Contact them to learn more about this unique program and how we can support you in your homeownership journey.

For more information about Line of Duty Death Mortgage Assistance please contact our mortgage advisor here.

Office: 805-668-3929 Mobile: 805-400-8585 Fax: 805-635-8962 www.teamzoeloans.com zoe.raithel@ccm.com. 1925 Spring Street, Unit A
Paso Robles, CA 93446

Mortgage Advisor

Zoe Raithel

Personal NMLS894102
Branch NMLS2023965
Company NMLS3029

LINE OF DUTY DEATH ASSISTANCE APPLICATION ELECTRONIC SUBMISSION

Apply for Assistance Now

*****

Apply for Assistance Now *****

PLEASE COMPLETE THE FOLLOWING INFORMATION

PSO (Public Service Officer) Information

First Name

Last Name

Date of Birth

Date of End of Watch (Death)

Home Mailing Address

Email

Home Phone / Mobile Number

(###)

###

####

Agency Name and Address

CONTACT PERSON NAME / EMAIL / PHONE#

BENEFICIARY INFORMATION ON FILE WITH AGENCY: Pleas provide the following information: Name/Address/Phone # /email / relationship to the deceased

BENEFICIARY RELATIONSHIP WITH THE DECEASED

PSO Cause of Death: Please describe any relevant information.

Please submit a copy of incident report if available.

Does PSO death meet the 100 Club of Nevada definition for LODD?

See definition of LODD on the left side of this form.

Name of Agency Supervisor / Title

Phone/Email

(###)

###

####

Line of Duty Death (LODD) Definition

LODD must be associated with attempts to save life or property, or enforce the law. Traffic accidents are covered while responding to an emergency, but no benefit will be offered for non-emergency traffic accidents. One exception to non-emergency traffic accidents is if the accident was caused by an equipment failure or malfunction out of the control of the driver/operator.

The following are not covered under Line of Duty Death:

Any death due to natural causes, disease or routine, non-emergency event that could happen in any workplace or while off duty.
Any death that occurs off duty or due to routine duties that are non-emergency a, etc.) and are similar to off duty activities (e.g., eating, sleeping, exercising, non-emergency driving).
Please notify THE 100 CLUB OF NEVADA as soon as possible of a Line of Duty Death at:
775-515-8112

Submit completed form to: info@nv100club.org or nv100club@gmail.com

Or mail printed PDF form to:
100 CLUB OF NEVADA, P.O. Box 1408, Carson City, NV 89702

IRS 501(c)(3) charitable organization & Nevada Corporation.

OUR PROGRAMS

Ensuring First Responders and their families receive the help they need when it matters most.