Laserfiche WebLink
<br />200809274 <br /> <br />MILITARY PAY VERIFICATION <br /> <br />20VO!D68 <br /> <br /> <br />TO: <br /> <br />Name & Address of Employer <br /> <br />Phone Number <br /> <br />Fax Number <br /> <br />RE: <br /> <br />Applicant/Tenant Name <br /> <br />Social Security Number <br /> <br />Unit # (if assigned) <br /> <br />I hereby authorize release of my military employment information. <br /> <br />Signature of Applicant/Tenant <br /> <br />Date <br /> <br />The individual named directly above is an applicant/tenant of a housing program that requires verification of income. The information provided will remain <br />confidential and will be used solely for the pU'lJOse of determining eligibility for occupancy. Your prompt response is crucial and greatly appreciated. <br /> <br />Signature of Owner's Representative <br /> <br />Return Form To: <br /> <br /> <br />Gross Earnings anticipated over next 12 months: <br /> <br />Monthly Base Pay <br /> <br />BAQ <br /> <br />Grade Level <br /> <br />FED-RATE <br /> <br />Probability of Continued Enlistment <br /> <br />Clothing Allowance <br /> <br />Commuted Rations <br /> <br />Hazardous Duty Pay <br /> <br />Other Special Pay <br /> <br />Total Monthly Entitlement <br /> <br />Year-to-date Earnings <br /> <br />Additional remarks: <br /> <br />Authorized Official Signature <br /> <br />Authorized Official Printed Name & Title <br /> <br />Date <br /> <br />Military Agency Address <br /> <br />Phone # <br /> <br />Fax # <br /> <br />E-mail <br /> <br />NOTE: Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false statements or misrepresentations to any Depanment or Agency of the <br />United States as to any maller within its jurisdiction. (Updated 11107) <br />