2026-2027 VFW Club/Bingo Manager Bond

A.1 Employee/Volunteer Theft (Crime Coverage)
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
Coverage Term: October 1, 2026 to September 30, 2027

1. Name of Post

Post #

Post Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

2. Name of Person Covered:

3. Position to be Covered:

4. Coverage Amount Requested:

5. Post Annual Income:

6. Has the post had any crime losses (Theft of Money by Employee/Volunteer) over the past 3 years?

If yes, please contact your Department for a Loss Questionnaire. No coverage can be extended until approved by insurance carrier.

If yes, explain:

7. Has the employee/volunteer ever been convicted of a dishonest or fraud employment related act?

8. If this is a replacement for a current position, please advise who you are replacing:

Number of Persons Covered: 1 Number of Locations: 1

Printed Name of Covered Person

Signature of Covered Person

Date

Contact Phone #

Format: (000) 000-0000.

NOTE: Questionnaire is not valid unless all questions are answered. Coverage may be postponed if not completed in FULL.

IF COVERAGE IS NOT RENEWED, TERMINATED, OR CANCELLED AT EXPIRATION DATE OF 10-1-2026, THE POST HAS ONLY 90 DAYS TO SUBMIT A PROOF OF LOSS FOR PRIOR TERM, AFTER 90 DAYS, PRIOR COVERAGE CEASES.

Form 4B - Revised 2026

IF YOU ARE GOING TO SEND A CHECK TO DEPARTMENT FOR THE PAYMENT DO NOT ENTER A PAYMENT AMOUNT BELOW.

MAIL CHECK TO:
VFW Dept of Colorado
1400 Carr St
Lakewood, CO 80214

Payment Amount

USDUse Cost for Amount Needed for Bond

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Afterpay

Questionnaire for Club Employees & Bingo Persons

Payment Amount

Payment Methods