Fillable Massachusetts Veterans Bonus Program - Veterans Of Older Wars Bonus Application

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Massachusetts Veterans Bonus Program - Veterans Of Older Wars Bonus Application

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The Massachusetts Veterans Bonus Program - Veterans Of Older Wars Bonus Application form is 3 pages long and contains:

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  • 27 check-boxes
  • 55 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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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
Bonus Application – Veterans of Older Wars for living
veterans who served in WWII, Korea War or Vietnam Conflict
Veteran 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)
Street Address:
City:
State:
Zip Code:
Service Information
Date of Entry:
Discharge Date:
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 Information
Check Bonuses applying for (only Eligible for 1 bonus per conflict)
Vietnam Conflict Bonus (July 1, 1958 – May 17, 1975)
Served in the country of
Vietnam - $300
Six months or more active service other than in Vietnam - $200
Korean War Bonus (June 25, 1950 – January 31, 1955)
One or more days overseas -
$300
Six months or more
stateside service - $200
90 days to 6 months stateside
service - $100
World War II (September 16, 1940 – July 25, 1947)
Foreign Service and Merchant
Marines - $300
Six or more months
stateside service - $200
One day to six months active
service - $100
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 Veterans' Bonus
1
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
Certificate of Massachusetts Residency Form
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
2
Reserve/Guard Activation Date
M
assachusetts Veterans' Bonus
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
Bonus Application Checklist – Older Wars for living
veterans who served in WWII, Korean War or Vietnam Conflict
Use this checklist to help you fill out the application form and provide a complete set of supporting
documentation to prove your eligibility for a veterans bonus from Massachusetts:
Application
Call or email Veterans’ Bonus Division to verify you did not receive the bonus when discharged
• Phone: (617)367-9333 Ext 859
•
Email: veteransbonus@tre.state.ma.us
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 name is different than when entered the military, include name change documentation
Check the bonus that you qualify for
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
Other Documentation - DD214
DD214 member 4 copy showing the character of service as honorable
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 Veterans' Bonus
3
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Completed 8 May 2020

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