HomeMy WebLinkAbout20131163.tiffCOLORADO DEPARTMENT OF MILITARY AND VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICERS- MONTHLY REPORT AND CERTIFICATION OF PAY
COUNTY of WELD Month of APRIL 2013
SECTION I: GENERAL INFORMATION
Telephone Calls
989
Office {Public Contacts)
280
Home Visits
Outreach Visits (Le. NH...)
1
Community Events/Forums
2
Request for Medals
4
Operation Recognition
Request for Medical Treatment Records
21-4142
1
21
Correspondence Received
102
Correspondence Written
130
Information and Referral/Inquiries
97
Other (i.e: VCAA Notice Response)
50
State Benefit(s)
12
Request far Military Records & Corrections
SF -180
15
DD 149
1
DD 293
NA 13075
3
Other{ )
SECTOR Ii: NEW CLAIMS INITIATED
[Provide number of new claims initiated for current reporting month]
21-22
21-22
CVA
Other
20
21-526
(SC - New/)
18
21-4138
(SC - Informal Claim)
214138
(SC - New Issue)
2,
21-4138
(SC -Reopen)
21-4138
(SC - Increase)
21.4138
(SC - SecOMillW oravarn)
21-4138
(SC - Reinstatement)
21.4138
(SC w/IU)
21.8940
(Ili)
21-4192
(I U - Employer)
21-4138
(SAM)
21.686c
3
NW Pension
21-526
2
21.527
686c
21-5261527 w! A&A
21-4138 (Reinstatement)
EVR (Any)
21-8416
6
5655
3
Request far Waivers/Compromise:
21-4136
5655 (FSR)
3
2
Dependent Indemntttr Compensatlon RDIC)
1-534
wl Accrued
Benefits
Death Pension ! Widows Pension
21-534
w/ Accrued Benefits
1
3
Request for VA Healthcare
10-10 EZ
16
10-10 EZ-R
8
10-583
10-10d (CHAMPVA - Dependents)
2
10-7959a (CHAMPVA)
1
10-7959C (CHAMPVA - Insurance Cert
1
Vocational Rehabilitation
28-1900 CH 31 I
4
28-1900 (Independent Living Program) J
Educational Assistants Programs
P1911 CH 33
14
VEAP CH 32
VNEraGI CH34
22-5490 CH 35
Sel Reservist NC, CH 1607
21.674
Miscellaneous Claims
21-8678 (Clothing Allowance)
21-4502 (Auto Grant I Adaptive Equipment)
28-4555 (Housing Grant)
1
10-0103 (HISA Grant)
1
Medicaid Application Assistance
SSA Application Assistance
Other (Specify)
Other (Specify)
Other (Specify)
CVA-26 (Revised en+20061
V h'
Gine
2013-1163
1/A coo/
SECTION II (Continued):
Burial Allowance
21-530
40-1330
21-2008
3
5
VA Home Loan
26-1800
26-1817
7
Homeless Veterans Claims Filed
SC
NSC
2
1
Incarcerated Veterans
21-4193 Release/Reinstatement
1
21-4138 (Apportionment)
1
Appeals
NOD
VA 9
6
Claims for Insurance
29 -357
29-4364
29-336 (Designation of Beneficiary)
21-4125 (Claim for Lump Sum Payment)
Requests wl VTF (Grant), 0 Vets Assisted
Rental Assistance
3
Utilities Assistance
4
Prescription Assistance !Other Medical
Food
27
Transportation
10
Clothing
Other
PRO Election
Review
4
Hearing
2
SECTION III: CERTIFICATION BY COUNTY VETERANS SERVICE OFFICER
I hereby certify, the above Captioned monthly report is true and accurate. I have been paid the following
amount(s) for the month of tpr , 2013 from (Ai c 1 t1 County:
Salary _ $3.832.45
Expenses
Office Space
Telephone $376.98
Office Supplies 8142.48
Travel
Training Conference
Other
Other
Total _ $4,351.98
-13
(Sigof County Veterans Service Officer) (Date)
SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE
In accordance with CRS,28 A7 J-hergby certify the accuracy of the Report (CVA-26, revised 9/1/20(2011)
William F. Garcia, Chair
WELD
County Commissioner or Designee of
County
MAY 1 3 2013 Date
This certification, submitted monthly. properly signed and executed. will be considered as application for the
monetary benefrts to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue
This corm is to be submitted by the 15th day of the following month. Mall t0:
Colorado Division of Veterans Mks
Attention: Director 8N Conroy
1355 S. Colorado Blvd., Suite 113, Bldg C
Denver, CO 80222 CVA-26 (RSard anaoo6)
a oi3-843
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