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Home My WebLink About20162778.tiffCOLORADO DEPARTMENT OF MILITARY AND VETERANS AFFAIRS COUNTY VETERANS SERVICE OFFICERS - MONTHLY REPORT AND CERTIFICATION OF PAY COUNTY OF WELD MONTH OF JULY 2016 SECTION I: GENERAL INFORMATION Telephone Calls 577 Office (Public Contacts) 481 Home Visits Outreach Visits (i.e. NH...) 1 Community Events/Forums 2 Request for Medals Operation Recognition 10 Request for Medical Treatment Records 21-4142 4 orrespondence Received 85 Correspondence Written 80 Information and Referral/Inquiries Other (i.e: VCAA Notice Response) State Benefit(s) 8 Request for Military Records & Corrections SF -180 18 DD149 1 DD 293 2 NA 13075 Other( ) SECTON II: NEW CLAIMS INITIATED [Provide number of new claims initiated for current reporting month] Appointed Representative: 21-22 CVA 46 21-22 Other Claims for SC Entitlement: 21-526 (SC - New/) 30 21-4138 (SC - Informal Claim) 20 21-4138 (SC - New Issue) 22 21-4138 (SC - Reopen) 12 21-4138 (SC -Increase) 21-4138 (SC - Secondarymmggravation) 21-4138 (SC - Reinstatement) 21-4138 (SC w/ IU) 21-8940 (IU) 21-4192 (IU - Employer) 21-4138 (SMC) 21-686c Non Service Connected Pension: 21-526 21-527 8 686c 2 21-526/527 w/ A&A 21-4138 (Reinstatement) EVR (Any) 21-8416 5655 Request for Waivers/Compromise: 21-4138 5655 (FSR) 2 Death Pension / Widows Pension 21-534 w/ Accrued Benefits 2 1 Request for VA Healthcare 10-10 EZ 15 10-10 EZ-R 8 10-583 10-10d (CHAMPVA - Dependents) 1 10-7959a (CHAMPVA) 10-7959C (CHAMPVA - Insurance Cert Vocational Rehabilitation 28-1900 28-1900 (Independent Living Program) CH 31 Educational Assistance Programs MGIB CH 30 8 VEAP CH 32 VN Era GI CH 34 22-5490 CH 35 4 Sel Reservist NG CH 1607 21-674 Miscellaneous Claims 21-8678 (Clothing Allowance) 21-4502 (Auto Grant / Adaptive Equipment) 26-4555 (Housing Grant) 10-0103 (HISA Grant) Medicaid Application Assistance SSA Application Assistance Other (Specify) f orternaA Iv L Own 8- 31-149 2016-2778 va.©OOI Dependent Indemnity Compensation (DIC) 21-534 w/ Accrued Benefits SECTION Burial Allowance 21-530 40-1330 1 21-2008 1 VA Home Loan 26-1800 26-1817 5 Homeless Veterans Claims Filed SC NSC Incarcerated Veterans 21-4193 Release/Reinstatement 21-4138 (Apportionment) Appeals NOD 1 VA 9 2 Other (Specify) Other (Specify) II (Continued): Claims for Insurance 29 -357 29-4364 29-336 (Designation of Beneficiary) 21-4125 (Claim for Lump Sum Payment) Requests w/ VTF (Grant), # Vets Assisted Rental Assistance Utilities Assistance Prescription Assistance / Other Medical Food Transportation Clothing Other DRO Election Review Hearing 1 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 Jul -16 COUNTY OF WELD Salary Expenses Office Space Telephone _ $ 291.02 Office Supplies Travel Training Conference Other Other $6,200.00 Total $ 6,491.02 (ignature of County Veterans Service Officer) (Date) TION IV: CERTIFICATION BY COUNTY COMMISSIONER OR DESIGNEE RS 28-5-707, I hereby edifythe accuracy of the Report (CVA-26, revised 9/1/20(2011) i Se. County Commissioner or Designee of .1661'. County 08/31/2016 Date This certification, submitted monthly, properly signed and executed, will be considered as application for the ao16-a�n� Hello