Get Application And Public Voucher For Advancementfrom The Vocational Rehabilitation Revolving Fund

Department of Veterans Affairs APPLICATION AND PUBLIC VOUCHER FOR ADVANCEMENT FROM THE VOCATIONAL REHABILITATION REVOLVING FUND D. O. VOUCHER NUMBER BUREAU VOUCHER NUMBER FILE NUMBER CLAIM NUMBER PAID BY THE UNITED STATES VETERAN NAME ADDRESS CITY STATE ZIPCODE FOR USE OF PAYING OFFICE APPLICATION FOR ADVANCE I request an advance of from the Vocational Rehabilitation Revolving Fund* If the advance is made I consent to collection of the amount advanced by deductions from my compensation pension subsistence allowance educational assistance allowance retirement or military retired or retainer pay or by other means necessary to make full recovery. I understand that if my training is discontinued or completed or I reach my program eligibility termination date before I have repaid the advance VA will withhold any monies due me until the advance is paid in full* SIGNATURE OF VETERAN DATE CERTIFICATE OF DESIGNATED OFFICER IN VOCATIONAL REHABILITATION AND COUNSELING DIVISION I CERTIFY THAT the applicant is receiving vocational rehabilitation services and I approve an advance in the amount of. Recovery of the funds will be made at the rate of per month from future payment of subsistence allowance compensation pension educational assistance allowance retirement military retired or retainer pay to which he or she is lawfully entitled* SIGNATURE AND TITLE STATION This voucher has been examined and found true and correct. SIGNATURE OF AUTHORIZED CERTIFYING OFFICER AMOUNT CERTIFIED ACCOUNTING CLASSIFICATION For completion by administrative officer APPROPRIATION SYMBOL TITLE 36X4114 PAID BY Check one CHECK Third Party Check AMOUNT VOCATIONAL REHABILITATION DEPARTMENT OF VETERANS AFFAIRS REVOLVING FUND BUREAU SCHEDULE OR ADP BATCH CONTROL NO. AMOUNT CASH SIGNATURE OF PAYEE Cash payment only VA FORM MAR-90 28-1910 EXISTING STOCKS OF VA FORM 28-1910 JUN 1986 WILL BE USED U*S* GPO 1982-343-134/3489. O. VOUCHER NUMBER BUREAU VOUCHER NUMBER FILE NUMBER CLAIM NUMBER PAID BY THE UNITED STATES VETERAN NAME ADDRESS CITY STATE ZIPCODE FOR USE OF PAYING OFFICE APPLICATION FOR ADVANCE I request an advance of from the Vocational Rehabilitation Revolving Fund* If the advance is made I consent to collection of the amount advanced by deductions from my compensation pension subsistence allowance educational assistance allowance retirement or military retired or retainer pay or by other means necessary to make full recovery. I understand that if my training is discontinued or completed or I reach my program eligibility termination date before I have repaid the advance VA will withhold any monies due me until the advance is paid in full* SIGNATURE OF VETERAN DATE CERTIFICATE OF DESIGNATED OFFICER IN VOCATIONAL REHABILITATION AND COUNSELING DIVISION I CERTIFY THAT the applicant is receiving vocational rehabilitation services and I approve an advance in the amount of. I understand that if my training is discontinued or completed or I reach my program eligibility termination date before I have repaid the advance VA will withhold any monies due me until the advance is paid in full* SIGNATURE OF VETERAN DATE CERTIFICATE OF DESIGNATED OFFICER IN VOCATIONAL REHABILITATION AND COUNSELING DIVISION I CERTIFY THAT the applicant is receiving vocational rehabilitation services and I approve an advance in the amount of. Recovery of the funds will be made at the rate of per month from future payment of subsistence allowance compensation pension educational assistance allowance retirement military retired or retainer pay to which he or she is lawfully entitled* SIGNATURE AND TITLE STATION This voucher has been examined and found true and correct.