Use this form to apply for assistance with the costs of Ignition Interlock Device (IID) installation, removal, and leasing the IID. A client who currently gets TANF, SFA, or RCA, may request AREN by: Completing the Emergency Assistance Request, DSHS 14-337(X), or.Financial Assistance Instructions and Plain Language Summary. This is an application for financial assistance (also known as charity care) at Mason Health. Below, you will find our forms available to complete for the current academic year. This program provides funding for clean and reliable drinking water systems, sanitary sewage disposal, sanitary solid waste disposal, and storm water drainage. Applicants must submit a Letter of Intent prior to submitting a full application. To place an order with us, customers must be currently participating in a government-based assistance program or have a qualifying household income. Applying for financial assistance can be easy. First, simply reach out to your monitoring authority or the state office that requires you to install an IID.