October 30, 2013 RE: CHRISTMAS DISBURSEMENT APPLICATION Dear band members, On behalf of our chief and council,

I am pleased to announce we will be providing Christmas assistance of $50 per Shubenacadie band member. Those Shubenacadie band members who have custody and/or control of Shubenacadie band members 17 years old and younger will receive an additional $50 dollars per minor Shubenacadie band member in their care and control. For example, a single parent family with three children will receive a total payment of $200 Enclosed with this letter is the application that must be completed and submitted to the band no later than December 10, 2013. The band will not accept any late applications under any circumstances. Submission Criteria Nina Jackson has been assigned to be the administrator for the Christmas Disbursement Program this year. All applications must be signed and dated accompanied with proof parental custody, if requested. The band reserves the right to request documentation such as, but not limited to, a court order or proof of marriage. For families who have both the mother and father living at the same residence, the Christmas Disbursement payment will be issued in the mother/wifes name. You can send your application by using the following methods: 1. MAIL TO Attn: Nina Jackson Shubenacadie Band 522 Church Street Indian Brook, NS B0N 1W0 2. Hand Delivery to the Band Office in Nina Jackson's Attention 3. Fax to: 902 758 2017 to Nina Jackson 4. Scan/Fax to email to njackson@shubenacadieband.ca Disbursements Christmas disbursement payments will be released at the band office from December 10 to December 20, 2013. Band members will be responsible for making suitable arrangements to collect their payment. If you wish to have your payment mailed, please check the box provided on the application page. Otherwise, band members will be expected to pick up their payment in person at the band office. Finally, be advised payments that are not picked up by January 20, 2014 will be cancelled.

In the Spirit of Christmas

Chief Rufus Copage Shubenacadie Band

****CHRISTMAS DISBURSEMENT APPLICATION 2013**** 1. LAST NAME: __________________________________________________________

2. FIRST NAME: 3. SPOUSE /COMMON-LAW

__________________________________________________________

__________________________________________________________

4. ADDRESS:

____________________________________________________ ____________________________________________________ ____________________________________________________ 3(a) Mail payment YES NO

5. BAND NUMER: __________________________________________ Ex: 0250000001 6. DATE OF BIRTH:_________________________________________ DD/MM/YYYY 7. Number Dependent Shubenacadie Band Members 17 years old and younger. Last Name First Name Age Band Number Requested Document

THIS SECTION IS FOR INTERNAL OFFICE USE ONLY

TOTAL Payment

Approval Signature

APPLICATIONS MUST BE SUBMITTED TO THE BAND BY DECEMBER 10, 2013 by 12:00 noon. THE BAND WILL NOT ACCEPT ANY LATE APPLICATIONS!!!!!!

Applicant Signature____________________________

Date____________________