CLUB BOND APPLICATION 2024-25

VFW QUESTIONAIRE FOR CLUB EMPLOYEES & BINGO PERSONS TO, BE COMPLETED BY COVERED INDIVIDUAL
THIS BOND APPLICATION CAN BE USED FOR BINGO CHAIRPERSON, CANTEEN MANAGER, AND SECRETARY. THIS FORM MUST BE COMPLETED IN FULL!
Coverage Term: October 1, 2024 to September 30, 2025
Name of Post*
Post*
Post Address*
Name of Person to be Covered*
Position to be Covered*
Coverage Amount Requested*
Post - Annual Income*
Has the Post had any crime coverage losses (Theft of Money by Employess) over the past three years?*
If yes, provide a description along with the date and amount of loss.
Has you ever been convicted of any dishonest or fradulent employement related acts, for example: burglary, robbery, theft, or embezzlement of funds of any kind?*
If yes, please explain
IF COVERAGE IS NOT RENEWED, TERMINATED, OR CANCELLED AT EXPIRATION DATE OF 10-1-2024, THE POST HAS ONLY 90 DAYS TO SUBMIT A PROOF OF LOSS FOR PRIOR TERM, AFTER 90 DAYS, PRIOR COVERAGE CEASES.
If this is a replacement for a current position, please advise what person you are replacing:
Signature of Person to be Covered:*

Clear
Date*

MonthDayYear
Date

CLUB BOND PAYMENT*

Club Bond Manager Bond Payment Price is $7.00 per 1,000. In the Quantity Section enter Number of 1,000. Example: For a 3,000 Bond - I would enter 3 in the Quantity section.

$7.00 Quantity
Item subtotal:$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

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Should be Empty:

VFW QUESTIONAIRE FOR CLUB EMPLOYEES & BINGO PERSONS TO, BE COMPLETED BY COVERED INDIVIDUAL

Coverage Term: October 1, 2024 to September 30, 2025

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