HomeMy WebLinkAbout961345.tiff CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH July 19 95
"° a ^ y?. zxa 2 ti ..a te a?'Sr Eta....
AWNEF , AND,SERVICEs MAINED `"0a r � R EVL ,x,.
TELEPHONE CALLS 289 MIL. RECORDS REQUEST (SF-180) 7
PUBLIC CONTACTS (OFFICE) 370 COMPENSATION 321
PUBLIC CONTACTS (HOME) s DIC 94
LETTERS WRITTEN 23 PENSION 381
21-22 - COLO VETERANS AFFAIRS 3 DEATH PENSION 324
21-22 - OTHER ORGANIZATIONS .1 INSURANCE 7
MEDICAID CASES 1 BURIAL ALLOWANCE 5
LOAN GUARANTY 5 VOC. REHAB & EDUCATION 10
MEDICAL BENEFIT CLAIMS 32 MISCELLANEOUS 6
STATE BENEFIT CLAIMS 2
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of July 19 95 from Weld County in
the amount of $2,409.90 dollars for my services as county veterans officer;
and in addition, that$206.75 dollars have been disbursed by said county for
�.. nses incurred in the operation of the county veterans service office, in
4 U! dance with 26-10-108, 1973 Colorado Revised tutes.
,v>' ? ce tify the accura of this Report.
Dorothy Strong eterans Counselo
'set �{`!� j � �`•„ �/. County Commissioner or eir designee of
Or" F -i l,d County
IN certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
""' .-`�,' aC rules"- 961345
7� ?/9� v AOOO
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH August 19 95
no itt �tspri RVXCES Gtths.. .� h 4 4 1TS�sS tincES ...w g ice,
» : ..�:�YW .,.... .:.;. h S}'....
TELEPHONE CALLS 275 NIL. RECORDS REQUEST (SF-180) 6
PUBLIC CONTACTS (OFFICE) 347 COMPENSATION 324
PUBLIC CONTACTS (HOME) . DIC 56
LETTERS WRITTEN 24 PENSION 389
21-22 - COLO VETERANS AFFAIRS 4 DEATH PENSION 328
21-22 - OTHER ORGANIZATIONS 5 INSURANCE 1
MEDICAID CASES 1R BURIAL ALLOWANCE 7
LOAN GUARANTY 4 YOC. REHAB & EDUCATION 8
MEDICAL BENEFIT CLAIMS 41 MISCELLANEOUS 15
STATE BENEFIT CLAIMS 3
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of August 1995 from Weld County in
the amount of $2,409.90 dollars for my services as county veterans officer;
and in addition, that $199. 12 dollars have been disbursed by said county for
AI It- ses incurred in the operation of the county veterans service office, in
#4 Z f-,tr nce with 26-10-108, 1973 Colorado Revised, tatutes.
��
.0,rh.�a c• tify the accura'y of this Report.
�l�i�
Ivry► � , Dorothy Strong eterans Counselor
1861 /y�,j.4 .4.44;M4= %_ 4 . ' ., County Commissioner ortheir designee of
O i C
�� Weld County
O` Iti- 40
♦mo.tra. certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH September 19 95
yy vg-• Y �o < -' ..,.. _ .... o �....�, N ) ... oz Yk„Mi're
55 Y
TELEPHONE CALLS 294 MIL. RECORDS REQUEST (SF-180) l0
PUBLIC CONTACTS (OFFICE) 359 COMPENSATION 326
PUBLIC CONTACTS (HOME) 5 DIC 57
LETTERS WRITTEN 29 PENSION 391
21-22 - COLO VETERANS AFFAIRS 4 DEATH PENSION 331
21-22 - OTHER ORGANIZATIONS . INSURANCE 7
MEDICAID CASES 15 BURIAL ALLOWANCE 6
LOAN GUARANTY 6 VOC. REHAB & EDUCATION 7
MEDICAL BENEFIT CLAIMS 45 MISCELLANEOUS 95
STATE BENEFIT CLAIMS 7
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of September 19 96 from Weld County in
the amount of $2,409.90 dollars for my services as county veterans officer;
and in addition, that $185.03 dollars have been disbursed by said county for
��:), nses "incurred in the operation of the county veterans service offi , in
r• 1, 14c% lance with 26-10-108, 1973 Colorado Revised atutes.
Ar i.rt` certify the accurac of this Report.
t`�tlMs& _ i& Dorothy Strong V terans Counselor
rO,‘2l ,, , / /b401.P/L County Commissioner or th designee of
I' r .A_, Weld County
O•�gn� certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Nail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH October 19 95
s ENE ti F ERincEs CLAIMED{ -167,-R Allititritsa$MVIceragiter e AN
TELEPHONE CALLS 283 MIL. RECORDS REQUEST (SF-180) 9
PUBLIC CONTACTS (OFFICE) 371 COMPENSATION 328
PUBLIC CONTACTS (HOME) 5 DIC 57
LETTERS WRITTEN 27 PENSION 394
21-22 - COLO VETERANS AFFAIRS 4 DEATH PENSION 334
21-22 - OTHER ORGANIZATIONS 5 INSURANCE 3
MEDICAID CASES 16 BURIAL ALLOWANCE 6
LOAN GUARANTY 3 VOC. REHAB & EDUCATION 11
MEDICAL BENEFIT CLAIMS 40 MISCELLANEOUS 82
STATE BENEFIT CLAIMS 2
I hereby certify that on this date July 10, 1996 , I have been paid a salary
1 for the month of October 19 95 from Weld County in
the amount of $2,409.90 dollars for my services as county veterans officer;
and in addition, that $207.28 dollars have been disbursed by said county for
0 _ •:,y. es incurred in the operation of the county veterans service ffice, in
40 IN Ik .-ice with 26-10-108, 1973 Colorado Revi* Statutes. -
[e ,,t"` ertify the accura y of this Report.
(411.1:1/49")/
N�M�. "`/ 1 Dorothy Strong Ve erans Counse r
1 517c,''� i!� , , �,L4-.� County Commissioner their designee
1 Weld County
` t �rtification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to;
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
; COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH November 1995
. � .. q �.iu C }S 4,5} 1tfV>S C C'
,iii SiRVICe,S EtAtio ;in- £�ht'S I l le
hY.>3lF�a.'.. '' .r>."�Cne x R a' xP
TELEPHONE CALLS 275 NIL. RECORDS REQUEST (SF-180) 9
PUBLIC CONTACTS (OFFICE) 391 COMPENSATION 330
PUBLIC CONTACTS (HOME) 5 DIC 58
LETTERS WRITTEN 19 PENSION 401
21-22 - COLO VETERANS AFFAIRS 5 DEATH PENSION 336
21-22 - OTHER ORGANIZATIONS 5 INSURANCE 2
MEDICAID CASES 18 BURIAL ALLOWANCE 7
LOAN GUARANTY 2 VOC. REHAB & EDUCATION 8
MEDICAL BENEFIT CLAIMS 36 MISCELLANEOUS 93
STATE BENEFIT CLAIMS 7
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of November 19 95 from Weld County in
the amount of $2,409.90 dollars for my services as county veterans officer;
and in addition, that $197. 14 dollars have been disbursed by said county for
I�1.;c wsence with 26 10-108, 1ed in the 973ation of the Colorado Revisoun county service offi e, in
0,v'' F li tify the accura of this Report. -- CA-An
l�w���, / D/ orothy Strong V terans Counselor
'1.. V({: � J r i ,.....4 County Commissioner or t it designee of II lh `:1 _-•. 4 Weld County
Sa_ it
%m 0.vicertification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
`' This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH December 19 95
i1 ....)ly, bF D1t .Q 3 9.. �,5�\'a �• Y' Y yaw,‘
TELEPHONE CALLS 267 MIL. RECORDS REQUEST (SF-180) 5
PUBLIC CONTACTS (OFFICE) 385 COMPENSATION .1,19
PUBLIC CONTACTS (HOME) 2 DIC 58
LETTERS WRITTEN 23 PENSION 410
21-22 - COLO VETERANS AFFAIRS 4 DEATH PENSION 338
21-22 - OTHER ORGANIZATIONS 6 INSURANCE 1
MEDICAID CASES 15 BURIAL ALLOWANCE
5
LOAN GUARANTY 2 VOC. REHAB & EDUCATION 5
MEDICAL BENEFIT CLAIMS 4.1 MISCELLANEOUS es
STATE BENEFIT CLAIMS
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of December 19 95 from Weld County in
the amount of $2,409.90 dollars for my services as county veterans officer;
nd in addition, that $185.71 dollars have been disbursed by said county for
• �r��*'r'y; es incurred in the operation of the county veterans service offi e, in
�� L� *t:nce with 26-10-108, 1973 Colorado Revised tutes.
� °Al h c tify the accur y of this Report.
1861
Dorothy Strong Vet ans Counse o'r—
tt
stfli .1 County Commissioner or th r designee of
OUP Weld County
~"" * s certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
1 Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
` COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH January 1996
�t i 5r304Ip ,$t:RVICES e4INE) N4. itziil�' 5 5 itYTCor 0 elif
TELEPHONE CALLS 289 NIL. RECORDS REQUEST (SF-180) 10
PUBLIC CONTACTS (OFFICE) 367 COMPENSATION 334
PUBLIC CONTACTS (HOME) 4 DIC 59
LETTERS WRITTEN 2' PENSION 413
21-22 - COLO VETERANS AFFAIRS 5 DEATH PENSION 340
21-22 - OTHER ORGANIZATIONS 6 INSURANCE 2
MEDICAID CASES 18 BURIAL ALLOWANCE S
LOAN GUARANTY VOC. REHAB & EDUCATION 11
2
MEDICAL BENEFIT CLAIMS 45 MISCELLANEOUS 87.
STATE BENEFIT CLAIMS 3
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of January 19 96 from Weld County in
the amount of $2,504.67 dollars for my services as county veterans officer;
and in addition, that $193.77 dollars have been disbursed by said county for
_x uses incurred in the operation of the county veterans service offipe, in
\,dance with 26-10-108, 1973 Colorado Revised tatutes.
4E a
.r ce tify the accurac of this Report.
TDorothy Strong V erans Counselor
'-� j i �� . ,cam , County Commissioner or eir designee of
tssrle"'Qt d '
44444
O �j Weld County
CuO
' certification submitted monthly, properly signed and executed, will be
sidered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
1
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH February 1996
1 €$ S SERVICES CL�[IME a x. (fL TS I# (3 ' f:I S', q ��` �Nff €
w..au„ .,......#o... : .. :. ... :r .. ..:.... � ,. vn4EY w`tv^.5�wi.xorH<,Y.N..g`�SRi. .T��fh
TELEPHONE CALLS 279 NIL. RECORDS REQUEST (SF-180) 9
PUBLIC CONTACTS (OFFICE) 376 COMPENSATION 336
PUBLIC CONTACTS (HOME) 2 DIC 59
LETTERS WRITTEN 24 PENSION 419
21-22 - COLO VETERANS AFFAIRS 5 DEATH PENSION 342
2
21-22 - OTHER ORGANIZATIONS 4 INSURANCE
MEDICAID CASES 19 BURIAL ALLOWANCE 3
LOAN GUARANTY 2 VOC. REHAB & EDUCATION 15
MEDICAL BENEFIT CLAIMS 45 MISCELLANEOUS 88
STATE BENEFIT CLAIMS 3
I\
I hereby certify that on this date July 10, 1996 I have been paid a salary
for the month of February 19 96 from Weld County in
the amount of $2,504.67 dollars for my services as county veterans officer;
and in addition, that $185.69 dollars have been disbursed by said county for
ti. ses incurred in the operation of the county veterans service office, in
4t1411E. iicAdvce with 26-10-108, 1973 Colorado Revised/Statutes.
�� ht, certify the acc r y of this Report.
t
',rik Dorothy Strong eterans Counsel
16611 ?r '`//�� ,�,_, ;,1g, 7 4/1/44 ,—/7 ,�,� yI�y4 County Commissioner or heir designee o
O olly(`.1' Weld County
`�tom' certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH March 19 96
Amentia S(:RYXCES nodal stioc; B s arinkS ty 3 � $ gr
:.:..oa`S �
TELEPHONE CALLS 269 MIL. RECORDS REQUEST (SF-180) 8
PUBLIC CONTACTS (OFFICE) 358 COMPENSATION 338
PUBLIC CONTACTS (HOME) 3 DIC 59
LETTERS WRITTEN 77 PENSION 421
21-22 - COLO VETERANS AFFAIRS DEATH PENSION iii
21-22 - OTHER ORGANIZATIONS 4 INSURANCE
2
MEDICAID CASES 15 BURIAL ALLOWANCE 7
LOAN GUARANTY 2 VOC. REHAB & EDUCATION t3
MEDICAL BENEFIT CLAIMS 42 MISCELLANEOUS -
82
STATE BENEFIT CLAIMS 3
I hereby certify that on this date .1„1 10, 1996 , I have been paid a salary
for the month of Marrh 19 96 from Weld County in
the amount of $2 SO4 67 dollars for my services as county veterans officer;
nd in addition, that $201 aQ dollars have been disbursed by said county for
s���" ses incurred in the operation of the county veterans service office, in
4 Lca ce with 26-10-108, 1973 Colorado Revised atutes.
`�� hA c tify the accurac of this Report.
1861Dorothy Strongeterahs Counselo
,�l ; t. County Commissioner or elf- designee of
oCIU; 1 - County
s certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH April 1996
......................................................................... ..
lIMDaSRVxCES CIJtTMEb '0'64:-.R $l $ 1#�D Sk1fC 5Nft;
TELEPHONE CALLS 263 MIL. RECORDS REQUEST (SF-180) 10
PUBLIC CONTACTS (OFFICE) 371 COMPENSATION 340
PUBLIC CONTACTS (HOME) 5 DIC 59
LETTERS WRITTEN 29 PENSION 424
21-22 - COLO VETERANS AFFAIRS DEATH PENSION 347
21-22 - OTHER ORGANIZATIONS 5 INSURANCE 2
MEDICAID CASES 16 BURIAL ALLOWANCE 7
LOAN GUARANTY 3 VOC. REHAB & EDUCATION
8
MEDICAL BENEFIT CLAIMS 45 MISCELLANEOUS 96
STATE BENEFIT CLAIMS 4
I hereby certify that on this date July 10, 1996 I have been paid a salary
for the month of April 1990 from Weld County in
the amount of $2,504.61 dollars for my services as county veterans officer;
and in addition, that Sd5.2u dollars have been disbursed by said county for
n4 IE Jt Sane with 26-10-108, 1973a ColoradoReviseun veterans service office, in
Statutes
` > r* certify the accura• of this Report_
v
Dorothy Strong Vetera s Counse r
IsG1
Ij
�� � � �� ,�! �. i - ;w( _� County Commissioner o their designee o
Weld County
certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH May 19 96
beet c setviCES GEMMED :.;::;140'."1,,;1 6tite 'S CAI SiItYI `.y lit:.;:
TELEPHONE CALLS 275 NIL. RECORDS REQUEST (SF-180) 11
PUBLIC CONTACTS (OFFICE) 391 COMPENSATION 342
1\ PUBLIC CONTACTS (HOME) 4 DIC
59
LETTERS WRITTEN PENSION 426
32
21-22 - COLO VETERANS AFFAIRS 4 DEATH PENSION 349
21-22 - OTHER ORGANIZATIONS 5 INSURANCE 2
MEDICAID CASES 18 BURIAL ALLOWANCE
5
LOAN GUARANTY 5 VOC. REHAB & EDUCATION 11
MEDICAL BENEFIT CLAIMS 41 MISCELLANEOUS R7
STATE BENEFIT CLAIMS
3
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of May 19 96 from Weld County in
the amount of $2,504.67 dollars for my services as county veterans officer;
nd in addition, that $210.31 dollars have been disbursed by said county for
Ii "� nses incurred in the operation of the county veterans service office, in
�� � .� fiance with 26-10-108, 1973 Colorado Revised atutes.
er c rtify the accur y of this Report.
Q .' / Dorothy Strong V terans Counselor
tam �
e '�u+‘ (5 �'^j�L21�4Q d t County Commissioner or eir designee of
O. u11 1 \4/, Weld County
is certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
CVA-26 (REV. 11/94)
COLORADO DEPARTMENT OF HUMAN SERVICES - DIVISION OF VETERANS AFFAIRS
COUNTY VETERANS SERVICE OFFICER'S MONTHLY REPORT AND CERTIFICATION OF PAY
Weld COUNTY MONTH June 19 96
s yBitgl1S ANN $ERYXCES c...A D ND, $E M A?N1I". ntviGt i 011401 .;,
TELEPHONE CALLS 309 MIL. RECORDS REQUEST (SF-180)
10
PUBLIC CONTACTS (OFFICE) 370 COMPENSATION
344
PUBLIC CONTACTS (HOME) DIC 60
5
LETTERS WRITTEN 26 PENSION
429
21-22 - COLO VETERANS AFFAIRS 4 DEATH PENSION
352
21-22 - OTHER ORGANIZATIONS 6 INSURANCE
3
MEDICAID CASES 15 BURIAL ALLOWANCE
7
LOAN GUARANTY 5 VOC. REHAB & EDUCATION
9
MEDICAL BENEFIT CLAIMS 41 MISCELLANEOUS
75
STATE BENEFIT CLAIMS 3
I hereby certify that on this date July 10, 1996 , I have been paid a salary
for the month of June 19 96 from Weld County in
the amount of $2,504.67 dollars for my services as county veterans officer;
d in addition, that $198.76 dollars have been disbursed by said county for
„. ue t�ses incurred in the operation of the cou x veterans service office, in
�" Y `ante with 26-10-108, 1973 Colorado Revise t tutes.
v
1861
0 certify the accurac of this Report.
k mid '$ Dorothy Strong et ran's Counselor
S 21/clt f County Commissioner or eir designee of
®UN 4,1 Weld County
This certification submitted monthly, properly signed and executed, will be
considered as application for the monetary benefits payable to the County General
Fund, in accordance with 26-10-108, 1973 Colorado Revised Statutes.
This form should be submitted before the 15th of the following month. Mail to:
Colorado Department of Human Services, Division of Veterans Affairs, 789 Sherman
Street, Suite 460, Denver, CO 80203.
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