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Question	Answer
Form Name	Sweet Frog Hiring Form
Form Length	2 pages
Fillable?	Yes
Fillable fields	64
Avg. time to fill out	13 min 22 sec
Other names	sweet frog applications, sweet application, sweet frog job application, sweetfrog careers

12

Form Preview Example

	OMB Control No. 2900-0101
	Respondent Burden: 30 minutes
	Expiration Date: 06/30/2021
FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN

FIRST NAME - MIDDLE NAME - LAST NAME OF SURVIVING SPOUSE	IMPROVED PENSION ELIGIBILITY
	VERIFICATION REPORT
	(SURVIVING SPOUSE WITH NO CHILDREN) 8

COMPLETE MAILING ADDRESS OF SURVIVING SPOUSE	VA FILE NUMBER

	VA REGIONAL OFFICE RETURN ADDRESS

IMPORTANT - Please read the enclosed EVR Instructions (VA Form 21P-0510) prior to completing this form.

1A. YOUR SOCIAL SECURITY NUMBER

1B. VETERAN'S SOCIAL SECURITY NUMBER

1C. YOUR DATE OF BIRTH (Mo., day, yr.)

2.YOUR MARITAL STATUS (Check only one box)

(1) I HAVE NOT REMARRIED SINCE THE VETERAN DIED (You have not married anyone since the veteran's death.)

(2)		I REMARRIED ON		(Date) AND I AM STILL MARRIED (You married after the veteran's death and you are currently

		married. Enter the date you married your current spouse.)

(3)		I REMARRIED AFTER THE VETERAN DIED BUT THE MARRIAGE ENDED BY DEATH OR DIVORCE ON	.
		(You remarried but you are not currently married. Show the date your latest marriage ended.)

3. NUMBER OF UNMARRIED, DEPENDENT CHILDREN (See Paragraph 1 of the EVR Instructions)

IN YOUR CUSTODY						NOT IN YOUR CUSTODY

AMOUNT CONTRIBUTED DURING PAST 12 MONTHS TO CHILDREN NOT IN YOUR CUSTODY $


4A. ARE YOU A PATIENT IN A NURSING HOME?									4C. ENTER THE NAME, COMPLETE ADDRESS, AND
									TELEPHONE NUMBER OF NURSING HOME
		YES		NO (If "Yes", Complete Items 4B thru 4D. If "No", go to Item 5.)					(Please include Zip Code)
									(Please include Zip Code)




4B. SHOW THE DATE YOU ENTERED THE NURSING HOME

4D. DOES MEDICAID COVER ALL OR PART OF YOUR NURSING HOME FEES?

YES NO

5.DID YOU RECEIVE ANY WAGES OR WERE YOU EMPLOYED AT ANY TIME DURING THE PAST 12 MONTHS?

		YES		NO

6. DO YOU RECEIVE ANY OTHER VA BENEFITS AS A VETERAN, PARENT, OR SURVIVING SPOUSE?

		YES			NO	(If "Yes", write in the VA file number of the other benefit.)


VA FORM			21P-0518-1				SUPERSEDES VA FORM 21-0518-1, APR 2015,		PAGE 1
JUN 2018			21P-0518-1				WHICH WILL NOT BE USED.

7A. MONTHLY INCOME (Read Paragraphs 2 and 3 of the EVR Instructions)

If no income or net worth was received from a particular source, write "0" or "none". VA WILL INTERPRET A BLANK SPACE AS "NONE" OR "0."

SOURCE	SURVIVING SPOUSE
SOCIAL SECURITY	$
	$

U.S. CIVIL SERVICE

U.S. RAILROAD RETIREMENT

MILITARY RETIREMENT

OTHER (Show Source)

OTHER (Show Source)

7B. ANNUAL INCOME (Read Paragraphs 2 and 4 of the EVR Instructions)

If no income was received from a particular source, write "0" or "none". VA WILL INTERPRET A BLANK SPACE AS "NONE" OR "0."

NOTE: Report annual income for the dates indicated. If no dates are shown above the columns that follow, then report last calendar year (January through December) income in the left-hand column and current calendar year income in the right-hand column.

SOURCE	FROM:	FROM:
SOURCE
	THRU:	THRU:

GROSS WAGES FROM	$	$
ALL EMPLOYMENT	$	$
TOTAL INTEREST AND
DIVIDENDS

ALL OTHER
(Show Source)

ALL OTHER
(Show Source)

7C. DID ANY INCOME CHANGE (Increase/Decrease) DURING PAST 12 MONTHS? (Answer "NO" if there were no income changes or if the only change was a Social Security/VA cost-of-living adjustment. Answer "YES" if there were any other income changes or if you received any NEW source of income or any ONE-TIME income)

YES

NO

(If "YES", complete Items 7D through 7F. If "NO", go to Item 7G.)

7D. WHAT INCOME CHANGED? (Show what income changed, for example, wages, city pension, etc.)

7E. WHEN DID THE INCOME CHANGE?

(Show the dates you received any new income or the date income changed)

7F. HOW DID INCOME CHANGE? (Explain what happened; for example, quit work, got raise, received inheritance)

	7G. NET WORTH (Read Paragraph 5 of the EVR Instructions)

SOURCE		SURVIVING SPOUSE

CASH/NON- INTEREST-BEARING BANK ACCOUNTS		$
		$

INTEREST-BEARING BANK ACCOUNTS

IRA'S, KEOGH PLANS, ETC.

STOCKS, BONDS, MUTUAL FUNDS, ETC.

REAL PROPERTY (Not your home)

ALL OTHER PROPERTY

8.FAMILY MEDICAL EXPENSES (Read Paragraph 6 of the EVR Instructions)

Normally, medical expenses are reported at the end of the year. If you are using this form as your annual Eligibility Verification Report and Paragraph 6 of the EVR Instructions indicates that you should report medical expenses, use VA Form 21P-8416, Medical Expense Report, to report your medical expenses. If you are using this form as a supplement to a pending claim, you do not need to report medical expenses. If entitlement is established, you will have an opportunity to report your medical expenses at the end of the year.

9.SURVIVING SPOUSE'S EDUCATIONAL AND VOCATIONAL REHABILITATION EXPENSES (Read Paragraph 7 of the EVR Instructions). Show amounts paid by you during the past 12 months. DO NOT REPORT CHILDREN'S EXPENSES.

$

10A. SIGNATURE OF PAYEE (Read paragraph 9 of the EVR Instructions before signing)

10B. DATE SIGNED

10C. TELEPHONE NUMBERS (Include Area Code)

DAYTIME	EVENING

PENALTY: The law provides severe penalties which include fine or imprisonment, or both, for the willful submission of any statement or evidence of a material fact, knowing it is false, or fraudulent acceptance of any payment to which you are not entitled.

VA FORM 21P-0518-1, JUN 2018

PAGE 2

How to Edit Sweet Frog Hiring Form Online for Free

The sweet frog job applications completing course of action is easy. Our editor lets you work with any PDF document.

Step 1: To begin the process, select the orange button "Get Form Now".

Step 2: At the moment, you can start modifying your sweet frog job applications. The multifunctional toolbar is at your disposal - insert, erase, transform, highlight, and perform several other commands with the words and phrases in the document.

The next sections are contained in the PDF document you'll be completing.

part 1 to completing sweet frog applications

Provide the appropriate data in the C, YOUR, DATEOFBIRTH, Mo, day, yr YOUR, MARITAL, STATUS, Check, only, one, box I, REMARRIED, ON IN, YOUR, CUSTODY and NOT, IN, YOUR, CUSTODY area.

Filling in sweet frog applications step 2

The application will request you to write some significant details to automatically fill in the segment A, ARE, YOU, A, PATIENT, IN, A, NURSING, HOME YES, YES, YES, YES, VA, FORM, JUN and Page.

step 3 to entering details in sweet frog applications

Inside the part SURVIVING, SPOUSE SOURCE, SOCIAL, SECURITY US, CIVIL, SERVICE US, RAILROAD, RETIREMENT MILITARY, RETIREMENT OTHER, Show, Source OTHER, Show, Source FROM, THRU, FROM, THRU, SOURCE, ALLOTHER, Show, Source and ALLOTHER, Show, Source include the rights and responsibilities of the sides.

step 4 to completing sweet frog applications

Review the sections what, income, changed, for, example, wages city, pension, etc raise, received, inheritance SOURCE, SURVIVING, SPOUSE CASH, NON, INTEREST, BEARING, BANK, ACCOUNTS INTEREST, BEARING, BANK, ACCOUNTS IRAS, KEO, GH, PLANS, ETC STOCKS, BONDS, MUTUAL, FUNDS, ETC REAL, PROPERTY, Not, your, home ALL, OTHER, PROPERTY B, DATE, SIGNED DAYTIME, EVENING, and C, TELEPHONE, NUMBERS, Include, Area, Code and thereafter complete them.

Filling in sweet frog applications part 5

Step 3: At the time you click the Done button, your final file is easily exportable to every of your devices. Or, you will be able to deliver it through mail.

Step 4: Produce around a couple of copies of the document to avoid any sort of future challenges.

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