Va Form 28 1910 is a required form for all veterans seeking medical benefits through the Department of Veterans Affairs. The form is used to determine eligibility and calculate benefits. Completed correctly, the form can help ensure that veterans receive the health care they deserve. In this blog post, we'll provide an overview of Va Form 28 1910 and explain how to complete it.
You will discover information about the type of form you need to fill out in the table. It will tell you the time you will need to finish va form 28 1910, exactly what fields you will have to fill in and several further specific details.
| Question | Answer |
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| Form Name | Va Form 28 1910 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | 281910, 28 1910 fillable, va 1910 form, 28 1910 online |
Department of Veterans
Affairs
APPLICATION AND PUBLIC VOUCHER FOR ADVANCEMENT
FROM THE VOCATIONAL REHABILITATION REVOLVING FUND
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D.O. VOUCHER NUMBER |
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BUREAU VOUCHER NUMBER |
FILE NUMBER |
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<CLAIM NUMBER> |
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PAID BY |
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THE UNITED STATES |
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<VETERAN NAME> |
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<ADDRESS> |
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<CITY, STATE, ZIPCODE> |
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(FOR USE OF PAYING OFFICE) |
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APPLICATION FOR ADVANCE |
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I request an advance of |
from the Vocational Rehabilitation Revolving Fund. If the advance is made, I consent to collection of the |
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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 |
ADDRESS |
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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 |
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of the funds will be made at the rate of |
per month from future payment of subsistence allowance, compensation, pension, |
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educational assistance allowance, retirement, military retired or retainer pay to which he or she is lawfully entitled. |
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SIGNATURE AND TITLE |
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STATION |
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DATE |
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343/ |
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CERTIFICATE OF DESIGNATED OFFICER IN FINANCE ACTIVITY
I CERTIFY THAT the applicant will begin to receive or is receiving vocational rehabilitation services under chapter 31, Title 38, U.S. code. This voucher has been examined and found true and correct.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICER |
AMOUNT CERTIFIED |
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ACCOUNTING CLASSIFICATION
(For completion by administrative officer)
APPROPRIATION
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TITLE |
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AMOUNT |
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36X4114 |
VOCATIONAL REHABILITATION DEPARTMENT |
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OF VETERANS AFFAIRS REVOLVING FUND |
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PAID BY (Check one) |
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BUREAU SCHEDULE OR ADP BATCH |
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DATE |
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CHECK |
(Third Party Check) |
CONTROL NO. AMOUNT |
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CASH |
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SIGNATURE OF PAYEE (Cash payment only) |
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DATE |
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VA FORM |
EXISTING STOCKS OF VA FORM |
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*U.S. GPO: |
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USED |
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