Fillable Commonwealth of Massachusetts Global War on Terrorism (GWOT) Welcome Home Bonus

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Commonwealth of Massachusetts Global War on Terrorism (GWOT) Welcome Home Bonus

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The Commonwealth of Massachusetts Global War on Terrorism (GWOT) Welcome Home Bonus form is 5 pages long and contains:

  • 5 signatures
  • 26 check-boxes
  • 182 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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Service Member Information
First Name:
Middle Initial:
Last Name:
Email:
Date of Birth:
SSN:
Gender:
Male Female
Phone Number:
Current Address (Check will be mailed to this address)
Apt:
City:
State:
Zip Code:
If living outside United Stated provide alternate contact information
Alt Contact Name:
Alt Contact Phone Number:
Street Address:
Apt:
City:
State:
Zip Code:
Service Information
Date of Entry:
Discharge Date:
(If applicable)
Branch of Service:
Grade:
Character of Service:
Date of Activation:
(Reserve/Guard)
Date Activation Ended:
(Reserve/Guard)
Active Duty:
Reserve:
National Guard:
Address at Time of Entry into Service or Activation for Reserve and National Guard personnel
Street Address:
Apt:
City:
State:
Zip Code:
Name when entered the service if different than current name (Name Change Documentation Required)
First Name:
Middle Initial:
Last Name:
Bonus and Deployment Information (
Check Bonuses applying for)
Iraq/Afghanistan
or Imminent Danger
Subsequent Iraq,
Afghanistan,
Imminent Danger
6 Continuous Months Stateside or
Overseas not imminent danger
Subsequent 6 continuous months stateside or
overseas deployments not imminent danger
Assignment/Deployment History
Include all assignments and deployments information that occurred after September 11, 2001. Documentation is required.
Date
Arrived
Date
Departed
Base/Ship
Country/
Body of water
Name of Operation
Imminent
Danger
Location?
Previously
Received
this Bonus?
Signature
How did you hear about the program?
I hereby swear under the pains and penalties of perjury that the information I have provided in this application is true and accurate.
Signature of Applicant:
Date:
Massachusetts GWOT Welcome Home
1
The Commonwealth of Massachusetts
Office of the State Treasurer
One Ashburton Place, 12
th
floor, Veterans’ Bonus
Boston MA 02108
(617)367-9333 Ext 859
Veteransbonus@tre.state.ma.us
Global War on Terrorism (GWOT) Welcome Home Bonus
Service from September 11, 2001 to present
click to sign
signature
click to edit
Continuation Page if needed
First Name:
Middle Initial:
Last Name:
Assignment/Deployment History
Include all Assignment and deployment information that occurred after September 11, 2001. Documentation is required.
Date
Arrived
Date
Departed
Base/Ship
Country/
Body of water
Name of Operation
Imminent
Danger
Location?
Previously
Received
this Bonus?
Signature
I hereby swear under the pains and penalties of perjury that the information I have provided in this application is true and accurate.
Signature of Applicant:
Date:
Massachusetts GWOT Welcome Home
2
The Commonwealth of Massachusetts
Office of the State Treasurer
One Ashburton Place, 12
th
floor, Veterans’ Bonus
Boston MA 02108
(617)367-9333 Ext 859
Veteransbonus@tre.state.ma.us
Global War on Terrorism (GWOT) Welcome Home Bonus
Service from September 11, 2001 to present
click to sign
signature
click to edit
Applicant’s Information (To be completed by applicant)
Bring a copy of your DD214 for the City/Town clerk to verify entry/activation date
Current Name
First Name:
Middle
Initial:
Last Name:
Name when entered the Armed Forces if different than above
First Name:
Middle
Initial:
Last Name:
Name of parent or legal Guardian if you were 18 or younger when entered the Armed Forces or Activated
First Name:
Middle
Initial:
Last Name:
Address at time entered the Armed Forces or Activated (Reserve/Guard)
Street Address:
Town/City:
State:
Zip Code:
Date Entered Armed Forces or Date(s) Activated (Reserve/Guard):
(DD214 Block 12A or Block 14)
City/Town Clerk Instructions: The above individual is applying for the Massachusetts Veterans’ Bonus. The laws for each bonus require that
the member must have lived in Massachusetts at least 6 months immediately prior to entering or being activated for the Reserve or National Guard
in the Armed Forces. Please verify with your city/town records that the member lived in Massachusetts for at least 6 months prior to entering the
Armed Forces or being activated if Reserve/Guard.
Certifying Official’s Information (To be completed by City/Town Official)
I hereby certify that, according to the official records of this
office the above individual or legal guardian if minor at the
time resided at:
Street Address & City/Town:
Resided at the above address on the date listed. At least six
months immediately prior to entering the Armed Forces or
being activate for Reserve/Guard personnel
As listed on the member’s DD214 Block 12A, Block 14 (Older
DD214s) or other documentation provided by the applicant
Date:
_______________________ _____________
Month Year
If entered January – June previous year is required
If entered July – December current year is required
Certifying Official’s Name:
Phone Number:
Title:
Name of City or Town:
City/Town Clerk’s Signature: __________________________ Date: _______________
Stamp Town/City seal in this area
Massachusetts GWOT Welcome Home
3
The Commonwealth of Massachusetts
Office of the State Treasurer
One Ashburton Place, 12
th
floor, Veterans’ Bonus
Boston MA 02108
(617)367-9333 Ext 859
Veteransbonus@tre.state.ma.us
Certificate of Massachusetts Residency Form
Reserve/Guard Activation DateDa
te Entered Armed Forces
click to sign
signature
click to edit
Massachusetts Veterans Bonus Program
Office of the State Treasurer
One Ashburton Place, Room 1207
Boston MA 02108
(617)367-9333 Ext 859
Veteransbonus@tre.state.ma.us
3
Global War on Terrorism Welcome Home Bonus
Commanding Officer Form (Attestation)
Required for Active Duty personnel only
If Commanding Officer is not available will accept signature from within your chain of command that can validate your service
The Commonwealth of Massachusetts awards state bonuses to individuals that lived in Massachusetts immediately before
entering the military and served from September 11, 2001 to present. One of the requirements is that the member had to serve
honorably. This form is to validate that the below active duty member is currently serving honorably.
Bonus Types & Amounts:
• $500 – Six continuous months active service stateside or overseas other than Iraq/Afghanistan or other DoD designated Imminent
Danger Location
• $1,000 – Service in Iraq/Afghanistan or other DoD designated Imminent Danger Location
Subsequent Bonuses (Multiple deployments):
• $250 – Subsequent deployments for six continuous months stateside or overseas in direct support of Operation Enduring Freedom,
Operation Iraqi Freedom, Operation Noble Eagle, Operation Inherent Resolve, Operation Freedom’s Sentinel, or any successor or
related operation other than Iraq/Afghanistan or other DoD designated Imminent Danger Location
• $500 – Subsequent deployment to Iraq/Afghanistan or other DoD designated Imminent Danger locations
Applicant Information:
First Name:
Middle Initial:
Last Name:
Active service for six continuous months stateside or overseas after September 11, 2001
Location: Arrival Date: Departure Date:
Served in Iraq, Afghanistan or other DoD designated Imminent Danger location
Location: Arrival Date: Departure Date:
Subsequent deployment in Iraq, Afghanistan or other DoD designated Imminent Danger location
Location: Arrival Date: Departure Date:
Subsequent deployment for six continuous months stateside or overseas in direct support of Operation Enduring
Freedom, Operation Iraqi Freedom, Operation Noble Eagle, Operation Inherent Resolve, Operation Freedom’s Sentinel,
or any successor or related operation other than Iraq/Afghanistan or other DoD designated Imminent Danger Location
Location: Arrival Date: Departure Date:
I hereby swear under the pains and penalties of perjury that the information I have provided in this application is true and accurate
Applicant’s Signature:
Date:
Commanding Officer or designee within the applicant’s chain of command
I attest that the above servicemember is serving honorably.
Printed Name, Rank:
Title
Email:
Commercial Phone Number:
Signature:
Date:
click to sign
signature
click to edit
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signature
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Application
Completed and signed
Correct Contact information phone and email
Correct current address (Check will be mailed to this address)
Include any special mailing instructions if required
If your address is currently outside the US, provide an alternate contact name and address
If name is different than when entered the military: include name change documentation
Proof of Residency
Correct residency year on Certificate of Residency
• City/town clerk must write the residency year showing 6 months residency in MA prior to entering or
being active (reserve/guard) in the Armed Forces
Entered/activated in the months January – June: write the prior year
Example: Entered February 2017 – Year on Residency form 2016
Entered/activated in the months of July – December: write the current year
Example: Entered August 2017 – Year on Residency form 2017
Certificate of Residency signed by city or town clerk with the seal
If using high school diploma, did you enter the military the same year that you graduated?
If using other documentation, must show your name and Massachusetts address prior to entering the military
Separated/Retired or Reserve/National Guard Documents
DD214 member 4 copy showing the character of service (Block 24)
If locations and dates are not listed on DD214, provide other documentation showing locations and dates of
deployment for active duty
Active Duty Documents – if you are currently serving
Documentation showing date entered military (Basic Information Records (BIR), Enlisted Records Brief (ERB),
Officer Records Brief (ORB), Single Unit Retrieval Format (SURF)
Documentation showing location and dates stationed or deployed (Orders/vouchers, evaluations, decorations,
awards, BIR, ERB, ORB, SURF, etc.)
Mail the completed application and supporting documentation to the below address:
(It is recommended to keep a copy of your application package)
Office of the State Treasurer (Veterans Bonus Program)
One Ashburton Place, Room 1207
Boston MA 02108
Massachusetts GWOT Welcome Home
5
The Commonwealth of Massachusetts
Office of the State Treasurer
One Ashburton Place, 12
th
floor, Veterans’ Bonus
Boston MA 02108
(617)367-9333 Ext 859
Veteransbonus@tre.state.ma.us
Global War on Terrorism (GWOT) Welcome Home Bonus
Service from September 11, 2001 to present
We recommend to complete the checklist to ensure that the application and supporting documentation are correct prior to
submitting the application package. If you have
any questions on what is required email or call the Veterans' Bonus Division.
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Commonwealth of Massachusetts Global War on Terrorism (GWOT) Welcome Home Bonus

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Completed 8 May 2020

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