HOW TO APPLY: SURVIVORS

WHAT YOU NEED TO ENROLL AS A SURVIVOR: RobertSimko2 In addition to the application form you will need copies of documents that show both your location in the affected area, and the time period you were there. Acceptable supporting documentation for survivors includes:

  • leases or utility bills with your name showing your residence between 9/11/01 and 7/31/02
  • pay stubs that show your work location between 9/11/01 and 7/31/02
  • letters from your employer, day care center, school, or volunteer organization that states your location between 9/11/01 and 7/31/02
  • student identification card with an associated date between 9/11/01 and 7/31/02
  • school transcript from the Fall 2001 semester.

If your home, work or school is not in the New York City Disaster Area, but on September 11, 2001, you were present in that area, your documentation could include copies of:

  • receipts showing the location and the date of September 11, 2001.
  • written statements of people who were with you or a detailed description of your activities in the New York City Disaster Area on September 11, 2001.

If you cannot get supporting documentation, please write a short report and send it in with your application form. In the report you can explain:

  • how you tried to find documentation of your presence in the area
  • why you cannot include documentation with your application.
    You can also submit a third party or personal attestation letter describing your presence in the World Trade Center disaster area including your location and the time period that you were there.

Completed application (first 4 pages) with documentation can be submitted by fax or mail. Fax to 877-646-5308 or mail to: World Trade Center Health Program PO Box 7000 Rensselaer, NY 12144 If you have any questions regarding submission, call the WTCHP at 888-882-4748.

CLICK HERE FOR SURVIVOR APPLICATION FORM

CLICK HERE TO APPLY ONLINE