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Home My WebLink About20080906.tiff State of Colorado Department of Military and Veterans Affairs ., , * Divison of Veterans Affairs •?�' . o �� COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: February , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 215 Appointed Representative: Office (Walk-ins) 160 21-22 CVA n Home Visits 0 21-22 Other 6 Outreach Visits (i.e. NH...) 0 Community Events/Forums n Service Connected Disability Compensation Correspondence Received 43 21-526 I(SC - New/) I 7 Correspondence Written 17 21-4138 - Other SC (Inc, Reopen, etc) 10 Information and Referral/Inquiries 51 Contacts: Both VAMC Vans 46 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 10 Non-Service Connected Pension DD 149/293 1 21-526 / 527 8 21-526/527 w/A&A 2 Request for Medical Treatment Records 21-4142 1 I I 2 Death Pension /Widows Pension 21-534 4 Request for Medals 2 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 1 21-530 .1 1 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 1 Request for VA Healthcare 10-10 EZ 4 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 0 CHAMPVA 0 CH 35 0 Miscellaneous Claims Claims for Disability Insurance Other (Specify)vp,.;f vA ;T,,,„ma. 9 29-357 / 29-4364 I e Other (Specify)5655 1 Other (Specify)21-8416 4 VA Home Loan Other (Specify) VCAA Notice 3 26-1800 / 1817 I 4 21-4125 1 CVA-18 4 Appeals CVA-42 4 NOD / DRO / VA9 I 2 V/ I CVA-2' ,n_..,_...,nninnn71 D3la /p8 2008-0906 # e o v(e-us) 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 February , 2<P7 from Weld County: Paid In-Kind Salary $ 4.023.52 Salary $ Expenses $ None Expenses $ Utilities County pays D*V utilities in lieu Utilities $ Office Space County gf rent p p�vs nAv ntili ies Office Space $ Telephone $ 98.23 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ 85.61 Office Supplies $ Postage $ 86.53 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,472.88 + utilitiesTOTAL $ (Signature of County V terans Service Offic (Date) Dorothy Strong, Vens Counselo for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR D, SIGNEE In accordance with CRS 28-5-707, I hereby certify the accu y of the Report (CVA- evised 2/1/2007): Dorothy Stro , Veterans Co elor 1, County Commissioner or Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs . yg x Divison of Veterans Affairs 2 ti i y ,,.«' COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: March , 20 07 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 193 Appointed Representative: Office (Walk-ins) 172 21-22 CVA 9 Home Visits 0 21-22 Other 8 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 38 21-526 I(SC - New/) I R Correspondence Written 19 21-4138 - Other SC (Inc, Reopen, etc) 9 Information and Referral/Inquiries 45 Contacts: Both VAMC vans 42 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 1 Military Records & Corrections SF-180 11 Non-Service Connected Pension DD 149/293 0 21-526 / 527 10 21-526/527 w/A&A 3 Request for Medical Treatment Records 21-4142 I I I 5 Death Pension /Widows Pension 21-534 3 Request for Medals 1 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 3 21-530 I 0 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 2 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 0 CH 30, 32, 34, 1607 0 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify) Verif.VA income 8 29-357 / 29-4364 I 1 Other (Specify) 5655 1 Other (Specify) 21-8416 6 VA Home Loan Other (Specify) VCAA Notice 8 26-1800 / 1817 I 5 21-4125 1 CVA-18 6 Appeals CVA-42 6 NOD / DRO / VA9 I 3 CVA-26(Revised 2/1/2007) 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 March , 20 07 from Weld County: Paid In-Kind Salary $ 4.023.52 Salary $ Expenses $ None Expenses $ UtiIItiesCounty pays D V utilities in lieu of rent Utilities $ Office Space County pvs DAV utilities Office Space $ Telephone $ 102.43 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 11.37 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,316.31 + utilitieIOTAL $ • - 7 06 (Signature of County terans Service Offi r (Date) Dorothy Strong, Ve erans Counselor for Pat Persichino, Veterans Service Office SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DES GNEE In accordance with CRS 28-5-707, I hereby certify the accur y of the Report CVA22 ed 2/1/2007): Dorothy Strong, eterans Couns or County Commissioner Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County Genera/Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs N. ,* Divison of Veterans Affairs SH� ,." COUNTY VETERANS SERVICE OFFICERS Fpi41.�PN� MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: April , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 251 Appointed Representative: Office (Walk-ins) 158 21-22 CVA 0 Home Visits 0 21-22 Other 9 Outreach Visits (i.e. NH...) 0 Community Events/Forums 1 Service Connected Disability Compensation Correspondence Received 48 21-526 1(SC - New/) I 6 Correspondence Written 16 21-4138 - Other SC (Inc, Reopen, etc) 11 Information and Referral/Inquiries 46 Contacts: Both VAMC vans 43 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 12 Non-Service Connected Pension DD 149/293 1 21-526 / 527 13 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 6 Death Pension /Widows Pension 21-534 9 Request for Medals 2 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 4 21-530 I 1 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 1 Request for VA Healthcare 10-10 EZ 1 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify)Verif. VA incoma 7 29-357 / 29-4364 I 0 Other (Specify) 5655 7 Other (Specify) 21-8416 6 VA Home Loan Other (Specify) VCAA Notice 6 26-1800 / 1817 I 6 21-4125 1 CVA-18 6 Appeals CVA-42 6 NOD / DRO / VA9 I 2 CVA-26(Revised 2/1/2007) 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 April , 20 07 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses $ None Expenses $ UtilitiesCounty pays D3V utilities ioflrent Utilities $ Office Space County pSys DAV utilities Office Space $ Telephone $ 172.54 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 5.55 Postage $ Travel $ No7e Travel $ Training Conference $ 709 27 Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 5,089.87 + utilities TOTAL $ cS— (Signature of County terans Service Offic (Date) Dorothy Strong, V erans Counselor or Pat Persichino, Veterans Service 0 fice SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accuracy e Report(CV -26, revise 2 1/2007): /� Dorothy Strong, Vet ans Counselor /4/u County Commissioner or D ignee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs , Divison of Veterans Affairs 10 as%+g T v sit "11 / COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: May , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS.INITIATED Telephone Calls 241 Appointed Representative: Office (Walk-ins) 151 21-22 CVA 0 Home Visits 0 21-22 Other 7 Outreach Visits (i.e. NH...) 0 Community Events/Forums 1 Service Connected Disability Compensation Correspondence Received 39 21-526 I(SC - New/) 1 9 Correspondence Written 12 21-4138 - Other SC (Inc, Reopen, etc) 14 Information and Referral/Inquiries 62 Contacts: Both VAMC vans 38 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 1 Military Records & Corrections SF-180 12 Non-Service Connected Pension DD 149/293 1 21-526 / 527 12 21-526/527 w/A&A 2 Request for Medical Treatment Records 21-4142 I I I 4 Death Pension /Widows Pension 21-534 1 Request for Medals 2 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 3 21-530 I 0 Request for VTF Grant Assistance n 1 Vocational Rehabilitation 28-1900 / CH 31 I 2 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 0 CH 30, 32, 34, 1607 0 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify)Verif. VA income 8 29-357 / 29-4364 I 0 Other (Specify) 5655 1 Other (Specify) 21-8416 5 VA Home Loan Other (Specify)VCAA Notice 5 26-1800 / 1817 I 4 21-4125 1 CVA-18 5 Appeals CVA-42 5 NOD / DRO / VA9 I 2 CVA-26(Revised 2/1/2007) 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 May , 20 07 from Weld County: Paid In-Kind Salary $ 4.023.52 Salary $ Expenses $ None Expenses $ Utilities County pays D$V utilities ir? lie Utilities $ o ren Office Space County p$ivs DAV utilities Office Space $ Telephone $ 173.30 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 17.95 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ .96.00 Other $ Other $ None Other $ TOTAL $ 4,393.76 + utilitiesTOTAL $ v3— 7-Oc- (Signature of County eterans ervice 0 er (Date) Dorothy Strong, Ve erans Counselo for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY OMMISSIONER OR DE IGNEE In accordance with CRS 28-5-707, I hereby certify the ac racy of the Re o (C r ised 2/1/2007): Dorothy Strong, Vet rans Counselo m' t— LLy County Commissions r Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs . ' , Divison of Veterans Affairs < 1 t, s sf COUNTY VETERANS SERVICE OFFICERS nry MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: June , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 218 Appointed Representative: Office (Walk-ins) 163 21-22 CVA 0 Home Visits 0 21-22 Other 5 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 45 21-526 I(SC - New/) I 8 Correspondence Written 18 21-4138 - Other SC (Inc, Reopen, etc) 9 Information and Referral/Inquiries Sa Contacts: Both VAMC vans 40 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 1 Military Records & Corrections SF-180 10 Non-Service Connected Pension DD 149/293 1 21-526 / 527 13 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 5 Death Pension /Widows Pension 21-534 2 Request for Medals 1 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 4 21-530 I 0 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 3 Request for VA Healthcare 10-10 EZ 2_— Educational Assistance Programs 10-10 EZ-R n CH 30, 32, 34, 1607 2 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify)verif. VA incoma 9 29-357 / 29-4364 I 0 Other (Specify) 5655 1 Other (Specify) 21-8416 7 VA Home Loan Other (Specify) VCAA Notice 4 26-1800 / 1817 1 5 21-4125 1 CVA-18 7 Appeals CVA-42 7 NOD / DRO / VA9 I 2 CVA-26(Revised 2/1/2007) 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 June ,20 07 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses $ None Expenses $ UtilitiesCounty pays D%V utilities Utilities $ o ren Office Space County p$ys DAV utilities Office Space $ Telephone $ 169.38 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 83.89 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ Other $ TOTAL $ 4,465.78 + utilities TOTAL $ (Signature of County V erans Service Offi r (Date) Dorothy Strong, Vet rans Counselor or Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accurac the Report C A-26 rev 2/1/2007): Dorothy Strong, Ve rans Counselo w' • County Commissioner or esignee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs . � W Divison of Veterans Affairs ' ` Am. "I ,�0a COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: July , 20 07 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 198 Appointed Representative: Office (Walk-ins) 149 21-22 CVA n Home Visits 0 21-22 Other 4 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 37 21-526 I(SC - New/) I 7 Correspondence Written 16 21-4138 - Other SC (Inc, Reopen, etc) 8 Information and Referral/Inquiries 43 Contacts: VAMC vans 36 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 10 Non-Service Connected Pension DD 149/293 0 21-526 / 527 8 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 4 Death Pension /Widows Pension 21-534 1 Request for Medals 0 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 2 21-530 I 1 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 J 1 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 2 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify)Verif. VA income 8 29-357 / 29-4364 I 1 Other (Specify) 5655 1 Other (Specify)21-8416 4 VA Home Loan Other (Specify)VCAA Notice 8 26-1800 / 1817 I 6 21-4125 1 CVA-18 4 CVA-42 4 Appeals NOD / DRO / VA9 I 1 CVA-26(Revised 2/1/2007) 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 July 2007 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses $ None Expenses $ UtilitiesCounty pays Dt$V utilities o re iy. lineu Utilities $ Office Space county p$vs DAV utilities Office Space $ Telephone $ 164.41 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 11.24 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,378. 16 + utilities TOTAL $ 3- 7-C (Signature of County teran Service O I er (Date) Dorothy Strong, terans Counse or for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accuracy f the Report( V -26, r /1/2007): I Dorothy Strong, Vet ans Counselor‘2. --' L, ,-2-i,,, County Commissioner or Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs . '°y Divison of Veterans Affairs ss COUNTY VETERANS SERVICE OFFICERS w MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: August , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 171 Appointed Representative: Office (Walk-ins) 143 21-22 CVA 1 Home Visits 0 21-22 Other 5 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 40 21-526 I(SC - New/) I R Correspondence Written 15 21-4138 - Other SC (Inc, Reopen, etc) 10 Information and Referral/Inquiries 41 Oontacts: VAMC vans 37 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 12 Non-Service Connected Pension DD 149/293 0 21-526 / 527 6 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 5 Death Pension /Widows Pension 21-534 2 Request for Medals 1 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 2 21-530 I 0 Request for VTF Grant Assistance [ 0 Vocational Rehabilitation 28-1900 / CH 31 I 1 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify) Verif. VA income 9 29-357 / 29-4364 I 0 Other (Specify) 5655 1 Other (Specify) 21-8416 6 VA Home Loan Other (Specify) VCAA Notice 6 26-1800 / 1817 I 7 21-4125 1 CVA-18 6 Appeals CVA-42 6 NOD / DRO / VA9 I 1 CVA-26(Revised 2/1/2007) 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 August , 2007 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses s $ None Expenses $ utilities County pays DI utilities o gait in e Utilities $ Office Spacecounty pa$rs DAV utilities Office Space $ Telephone $ 158.49 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 15.96 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,376.96 + utilities TOTAL 22 —7$ cJ — -Ok (Signature of County V terans Service Offi r (Date) Dorothy Strong, Veterans Counselor for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESI NEE In accordance with CRS 28-5-707, I hereby certify the accura of the Repo VA- r d 2/1/2007): I Dorothy Strong, terans Counse r k r r e County Commissioner Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs Divison of Veterans Affairs QN' 0 s COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: September , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 185 Appointed Representative: Office (Walk-ins) 153 21-22 CVA 0 Home Visits 0 21-22 Other 8 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 38 21-526 I(SC - New/) I A Correspondence Written 21 21-4138 - Other SC (Inc, Reopen, etc) 8 Information and Referral/Inquiries 36 Contacts: VAMU vans 39 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 1 Military Records & Corrections SF-180 12 Non-Service Connected Pension DD 149/293 1 21-526 / 527 6 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 4 Death Pension / Widows Pension 21-534 0 Request for Medals 2 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 1 21-530 I 1 Request for VTF Grant Assistance a Vocational Rehabilitation 28-1900 / CH 31 I 1 Request for VA Healthcare 10-10 EZ 1 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify) Verif. VA incone 7 29-357 / 29-4364 I 0 Other (Specify) 5655 2 Other (Specify) 21-8416 6 VA Home Loan Other (Specify) VCAA Notice 5 26-1800 / 1817 I 4 21-4125 1 CVA-18 6 Appeals CVA-42 6 NOD / DRO / VA9 I 2 CVA-26(Revised 2/1/2007) 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 September ,20 07 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses $ None Expenses $ UtilitiesCounty pays nh utilities i lie Utilities $ Office SpaceCounty p4s DAV utilities t Office Space $ Telephone $ 164.22 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 85.90 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $None Other $ TOTAL $ 4,452/63 + utilities TOTAL $ 1 ,9- 7-6g' (Signature of County eterans Service Off r (Date) Dorothy Strong, Veterans Counselor for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accuof the Report(CVA-26, vised 2/1/2007): Li r Dorothy Strong, Vete ans Counselor l • County Commissioner r Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs Divison of Veterans Affairs : cw?{ af be COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: October , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 137 Appointed Representative: Office (Walk-ins) 149 21-22 CVA 0 Home Visits 0 21-22 Other 7 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 36 21-526 I(SC - New/) I 7 Correspondence Written 16 21-4138 - Other SC (Inc, Reopen, etc) 9 Information and Referral/Inquiries 42 Jontacts: VAMC vans 39 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 10 Non-Service Connected Pension DD 149/293 0 21-526 / 527 7 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 5 Death Pension / Widows Pension 21-534 2 Request for Medals 1 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 3 21-530 I 0 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 2 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 0 Miscellaneous Claims Claims for Disability Insurance Other (Specify)Verif. VA income 8 29-357 / 29-4364 I 0 Other (Specify) 5655 1 Other (Specify) 21-8416 VA Home Loan Other (Specify) VCAA Notice 4 26-1800 / 1817 I 5 21-4125 1 CVA-18 5 Appeals CVA-42 5 NOD / DRO / VA9 I 0 CVA-26(Revised 2/1/2007) 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 October ,20 07 from Weld County: Paid In-Kind Salary $ 4.023.52 Salary $ Expenses $ None Expenses $ Utilities County pays D$V utilities iyr lier Utilities $ o ren Office Space County p$.ys may uti 1 ities Office Space $ Telephone $ 157.27 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 6.97 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,366.75 + utilities TOTAL $ (Signature of County Vet ns Service Officer (Date) Dorothy Strong, Vete s Counselor fo Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accur y of the Report CVA-26 r s d 2/1/2007): �� Dorothy Strong, Ve rans Counselor • County Commissioner esignee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs ., `��, ,* Divison of Veterans Affairs a " y p COUNTY VETERANS SERVICE OFFICERS n u MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: November , 20 07 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 191 Appointed Representative: Office (Walk-ins) 1 39 21-22 CVA 0 Home Visits 0 21-22 Other s Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 41 21-526 I(SC - New/) I 8 Correspondence Written 18 21-4138 - Other SC (Inc, Reopen, etc)10 Information and Referral/Inquiries 48 Contacts: VAMC vans 41 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 13 Non-Service Connected Pension DD 149/293 0 21-526 / 527 6 21-526/527w/A&A 0 Request for Medical Treatment Records 21-4142 I I I 6 Death Pension /Widows Pension 21-534 2 Request for Medals 2 w/Accrued Benefits 0 Operation Recognition n Burial Allowance Request for State Benefits: 3 21-530 I 0 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 3 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 0 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify)Verif. VA income 10 29-357 / 29-4364 I 0 Other (Specify) 5655 2 Other (Specify) 21-8416 5 VA Home Loan Other (Specify) VCAA Notice 7 26-1800 / 1817 I 6 21-4125 1 CVA-18 5 Appeals CVA-42 5 NOD / DRO / VA9 I 1 CVA-26(Revised 2/1/2007) 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 November 20 07 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses $ None Expenses $ Utilities County pays D$V „ti i i ti ec i lie Utilities $ Office Spac�ounty pads DAV utilit?eesrent Office Space $ Telephone $ 161.32 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ 38.49 Office Supplies $ Postage $ 13. 23 Postage $ Travel $None Travel $ Training Conference $None Training Conference $ Other Copier $ 96.00 Other $ Other $N „e Other $ TOTAL $ 4,465.55 + utilities TOTAL $ (Signature of County Vete ns Service Officer (Date) Dorothy Strong, Veterans Counselor for Pat Persichino, Veterans Service Officer • SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER O�yRy��D'DESIG In accordance with CRS 28-5-707, I hereby certify the accuracy of Report(C)/ 2 2/1/2007): / Dorothy Strong, Vet ans Counsel�r 'ft--; /Nr r County Commissioner or Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention:Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs ff Divison of Veterans Affairs `r k g / COUNTY VETERANS SERVICE OFFICERS e MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: December , 2007 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 142 Appointed Representative: Office (Walk-ins) 146 21-22 CVA 0 Home Visits 0 21-22 Other s Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 37 21-526 I(SC - New/) I 7 Correspondence Written 14 21-4138 - Other SC (Inc, Reopen, etc) 8 Information and Referral/Inquiries 52 Contacts: VAMC vans 40 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 12 Non-Service Connected Pension DD 149/293 0 21-526 / 527 5 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 3 Death Pension /Widows Pension 21-534 1 Request for Medals 0 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 4 21-530 I 1 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 2 Request for VA Healthcare 10-10 EZ 1 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 1 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify) Verif. VA incone 8 29-357 / 29-4364 I 0 Other (Specify) 9695 1 Other (Specify) 21-8416 6 VA Home Loan Other (Specify) VCAA Notice 5 26-1800 / 1817 I 7 21-4125 1 CVA-18 6 Appeals CVA-42 6 NOD / DRO / VA9 I 1 CVA-26(Revised 2/1/2007) 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 December .2007 from Weld County : Paid In-Kind Salary $ 4.023.52 Salary $ Expenses $ None Expenses $ Utilities County pays DIN utilities in lieu Utilities $ ren Office SpaceCounty pas DAV utili ties Office Space $ Telephone $ 155.86 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 87.06 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,445.43 + utilities TOTAL $ (Signature of County Vete ns Service Officer (Date) Dorothy Strong, Veterans Counselor for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accura o the Report 26, re d 2/1/2007): /�� Dorothy Strong, Vete ns Counselor County Commissioner or Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs x Divison of Veterans Affairs K CYn *: COUNTY VETERANS SERVICE OFFICERS no MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: January , 20 08 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 120 Appointed Representative: Office (Walk-ins) J5_3 21-22 CVA 0 Home Visits 0 21-22 Other 4 Outreach Visits (i.e. NH...) 0 Community Events/Forums n Service Connected Disability Compensation Correspondence Received 35 21-526 I(SC - New/) I 6 Correspondence Written 16 21-4138 - Other SC (Inc, Reopen, etc) 9 Information and Referral/Inquiries 47 contacts: VAMC vans 40 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 10 Non-Service Connected Pension DD 149/293 0 21-526 / 527 4 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 2 Death Pension / Widows Pension 21-534 9 Request for Medals 2 w/Accrued Benefits 0 Operation Recognition 0 Burial Allowance Request for State Benefits: 4 21-530 I 0 Request for VTF Grant Assistance 0 Vocational Rehabilitation 28-1900 / CH 31 I 1 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 0 CH 30, 32, 34, 1607 0 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify)Verif. VA income 7 29-357 / 29-4364 I 0 Other (Specify) 5b55 1 Other (Specify) 21-8416 5 VA Home Loan Other (Specify)VCAA Notice 6 26-1800 / 1817 I 6 21-4125 1 40-1330 0 Appeals 21-2008 o NOD / DRO / VA9 I 0 CVA-18 5 CVA-42 5 CVA-26(Revised 2/1/2007) 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 January , 20 08 from Weld County: Paid In-Kind Salary $ 4,023.52 Salary $ Expenses $ None Expenses $ Utilities County pays DiV utilities i lie Utilities $ Am Office SpaceCounty pairs DAV utilities Office Space $ Telephone $ 155.05 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 7.89 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,365.45 + utilities TOTAL $ (Signature of County Vete ns Service Officer (Date) Dorothy Strong, Veterans Counselor for Pat Persichino, Veterans Service Officer SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accur of the Report CVA-26 r i ed 2/1/2007): r Cf/ Dorothy Strong, V erans Counselor/ ' L z County Commissioner Designee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) State of Colorado Department of Military and Veterans Affairs Divison of Veterans Affairs k ..y r' COUNTY VETERANS SERVICE OFFICERS MONTHLY REPORT AND CERTIFICATION OF PAY County: Weld Month of: February , 2008 SECTION I: GENERAL INFORMATION SECTION II: NEW CLAIMS INITIATED Telephone Calls 270 Appointed Representative: Office (Walk-ins) 164 21-22 CVA 0 Home Visits 0 21-22 Other 8 Outreach Visits (i.e. NH...) 0 Community Events/Forums 0 Service Connected Disability Compensation Correspondence Received 37 21-526 I(SC - New/) I t; Correspondence Written 14 21-4138 - Other SC (Inc, Reopen, etc) 7 Information and Referral/Inquiries 41 Contacts: VAMC vans 38 Dependent Indemnity Compensation (DIC) Requests for: 21-534 I 0 Military Records & Corrections SF-180 9 Non-Service Connected Pension DD 149/293 0 21-526 / 527 4 21-526/527 w/A&A 1 Request for Medical Treatment Records 21-4142 I I I 3 Death Pension /Widows Pension 21-534 2 Request for Medals 4 w/Accrued Benefits 1 Operation Recognition 0 Burial Allowance Request for State Benefits: I 2 21-530 I 1 'Request for VTF Grant Assistance I 0 Vocational Rehabilitation 28-1900 / CH 31 I 2 Request for VA Healthcare 10-10 EZ 2 Educational Assistance Programs 10-10 EZ-R 1 CH 30, 32, 34, 1607 0 CHAMPVA 0 CH 35 1 Miscellaneous Claims Claims for Disability Insurance Other (Specify) Verif. VA incon e 6 29-357 / 29-4364 I 0 Other (Specify) 5655 1 Other (Specify) 21-8416 7 VA Home Loan Other (Specify)VCAA Notice 4 26-1800 / 1817 I 7 21-4125 1 40-1330 0 Appeals 21-2008 0 NOD / DRO / VA9 I 0 CVA-18 7 CVA-42 7 CVA-26(Revised 2/1/2007) 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 February ,20 OS from Weld County: Paid In-Kind Salary $ 4,164.34 Salary $ Expenses $ None Expenses $ Utilities County pays 3AV utilities i r lief Utilities $ o ren Office Space County p$vs DAV utilities Office Space $ Telephone $ 165.43 Telephone $ Internet $ 82.99 Internet $ Office Supplies $ None Office Supplies $ Postage $ 43.80 Postage $ Travel $ None Travel $ Training Conference $ None Training Conference $ Other Copier $ 96.00 Other $ Other $ None Other $ TOTAL $ 4,552.56 + utilities TOTAL $ c` - 7-O2-- (Signature of County Vet ans Service Officer (Date) Dorothy Strong, Veterans Counselor for Pat Persichino, Veterans Service Office SECTION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE In accordance with CRS 28-5-707, I hereby certify the accuracy .the Report(CVA-26, revi I .2/1/2007): Dorothy Strong, eterans Counse ;.,._ YL ` J County Commissioner or esignee (Signature) William H. Jerke, Chair County Commissioner or Designee of (Printed/Typed Name) Weld County 03/24/2008 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the monetary benefits to the County General Fund, in accordance with 28-5-804 (2002) Colorado Revised Statue. This form is to be submitted by the 15th day of the following month. Mail to: Colorado Division of Veterans Affairs Attention: Deputy Director 7465 E. 1st Avenue, Suite C Denver, CO 80230 CVA-26(Revised 2/1/2007) Hello