Search results
VERIFICATION OF EMPLOYMENT/LOSS OF INCOME. Date:________________________ ___________________________________________ In order to determine the eligibility of ___________________________________________ for public assistance, please assist us by answering the questions below and returning this form to us by __________________________ .
Verification of Employment/Loss of Income (CF-ES 2620) Download.
This form should be used to report or verify income and/or net worth. Changes to income and net worth over multiple years must be reported on a separate VA Form 21P-0969 for each year.
Completed forms can be uploaded to your MyACCESS account. Completed forms and/or paper applications may also be mailed to the ACCESS Central Mail Center, P.O. Box 1770, Ocala, FL, 34478-1770, faxed to 1-866-886-4342, or hand-delivered to a Family Resource Center .
Veterans have the opportunity to reduce their gross household income by providing amounts for out-of-pocket non-reimbursed deductible expenses for medical, burial, and Veteran’s education paid during the income year being verified.
Immigration papers/forms/cards (copy of both sides) Other proof from immigration (USCIS), such as: work authorization, letter of decision or court order on your case, etc. Note: All documents and forms will be verified through the Systematic Alien Verification for Entitlement (SAVE)
In order to determine eligibility, the department must have verification of all income and resources. Please complete Section II. Attached is a signed authorization for the release of this information. In order to establish the individual’s eligibility as quickly as possible, we are requesting your response by _____________________ (10 days).
