CTMD Form 2-1 "Wartime Service Bonus Application" - Connecticut

What Is CTMD Form 2-1?

This is a legal form that was released by the Connecticut Military Department - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2013;
  • The latest edition provided by the Connecticut Military Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CTMD Form 2-1 by clicking the link below or browse more documents and templates provided by the Connecticut Military Department.

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Download CTMD Form 2-1 "Wartime Service Bonus Application" - Connecticut

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CTMD Form 2-1
(Rev 5/2013)
CONNECTICUT MILITARY DEPARTMENT
INSTRUCTIONS FOR
WARTIME SERVICE BONUS APPLICATION
PURPOSE: The Wartime Service Bonus was established for the purpose of making grants to eligible service members of
the Connecticut National Guard who served on active duty on or after September 11, 2001.
ELIGIBILITY: In order to be eligible for the Wartime Service Bonus, the service member must:
1. be a current member of the Connecticut National Guard who was called to active service as a member of the
National Guard or Reserves (USAR, USMCR, USNR) on or after September 11, 2001 or;
2. be a former member of the Connecticut National Guard who was called to active service as a member of the
National Guard on or after September 11, 2001 and;
3. have served on active duty (Title 10) for at least 90 consecutive days in support of military operation and;
4. have been honorably discharged or discharged for injuries sustained in the line of duty.
LIMITATIONS:
Service member will receive $50.00 for every eligible month up to a maximum of $500.00 for those who do
not serve in a combat zone and a maximum of $1,200.00 for those who do serve in a combat zone as
designated by the President of the United States.
Service member must spend at least 15 days of a month on active duty (Title 10) in order to qualify that
month for payment. (14 days for February).
Service must have been served in support of a military operation. Active Duty for Training and regular Active
Duty service do not qualify for the Wartime Service Bonus.
The application must be received within three years of cessation of the military operation in which the service
member participated. Applications can be sent in three years after the performance of active duty service as
long as the military operation has not ceased within the last three years (i.e.: Operation Noble Eagle,
Operation Iraqi Freedom, Operation Enduring Freedom, etc.)
DOCUMENTATION:
1. Completed and signed application form (CTMD Form 2-1)
2. Copy of DD Form 214
3. Copy of Travel Voucher and Military Orders for Air National Guard members who did not receive a DD Form 214
For more information visit http://www.ct.gov/mil/wsp or call (860) 524-3239 or (860) 524-4968
SEND APPLICATIONS & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
Wartime Service Bonus
360 Broad Street - Room #113
Hartford, Connecticut, 06105-3795
(860) 493-2721 (fax)
(860) 524-3239
or
(860) 548-4968
CTMD Form 2-1
(Rev 5/2013)
CONNECTICUT MILITARY DEPARTMENT
INSTRUCTIONS FOR
WARTIME SERVICE BONUS APPLICATION
PURPOSE: The Wartime Service Bonus was established for the purpose of making grants to eligible service members of
the Connecticut National Guard who served on active duty on or after September 11, 2001.
ELIGIBILITY: In order to be eligible for the Wartime Service Bonus, the service member must:
1. be a current member of the Connecticut National Guard who was called to active service as a member of the
National Guard or Reserves (USAR, USMCR, USNR) on or after September 11, 2001 or;
2. be a former member of the Connecticut National Guard who was called to active service as a member of the
National Guard on or after September 11, 2001 and;
3. have served on active duty (Title 10) for at least 90 consecutive days in support of military operation and;
4. have been honorably discharged or discharged for injuries sustained in the line of duty.
LIMITATIONS:
Service member will receive $50.00 for every eligible month up to a maximum of $500.00 for those who do
not serve in a combat zone and a maximum of $1,200.00 for those who do serve in a combat zone as
designated by the President of the United States.
Service member must spend at least 15 days of a month on active duty (Title 10) in order to qualify that
month for payment. (14 days for February).
Service must have been served in support of a military operation. Active Duty for Training and regular Active
Duty service do not qualify for the Wartime Service Bonus.
The application must be received within three years of cessation of the military operation in which the service
member participated. Applications can be sent in three years after the performance of active duty service as
long as the military operation has not ceased within the last three years (i.e.: Operation Noble Eagle,
Operation Iraqi Freedom, Operation Enduring Freedom, etc.)
DOCUMENTATION:
1. Completed and signed application form (CTMD Form 2-1)
2. Copy of DD Form 214
3. Copy of Travel Voucher and Military Orders for Air National Guard members who did not receive a DD Form 214
For more information visit http://www.ct.gov/mil/wsp or call (860) 524-3239 or (860) 524-4968
SEND APPLICATIONS & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
Wartime Service Bonus
360 Broad Street - Room #113
Hartford, Connecticut, 06105-3795
(860) 493-2721 (fax)
(860) 524-3239
or
(860) 548-4968
CTMD Form 2-1
(Rev 5/2013)
CONNECTICUT MILITARY DEPARTMENT
WARTIME SERVICE BONUS APPLICATION
SERVICE MEMBER’S PERSONAL INFORMATION
Last Name
First Name
Middle Initial
Street Address
City
State
Zip-Code
Social Security Number
Military Rank
Branch of Service
Current Member of CTNG
Phone Number
E-Mail
Army
Yes
Air Force
No
HISTORY OF ACTIVE DUTY SERVICE
(List all deployments since September 11,2001)
Unit assigned
Component
Name of Operation
Characterization of
Dates of Active Duty Service
Dates Served in Combat Zone
to prior to
(National Guard,
(Enduring Freedom,
Service
Start
End
Start
End
active duty
Reserves, etc)
Iraqi Freedom, etc)
(Block 24 of DD214)
(Block 12a)
(Block 12b)
(Block 18)
(Block 18)
INFORMATION VERIFICATION, ACCESS & RELEASE AUTHORIZATION
I authorize verification/release of the information I am providing on this application. This authorization allows the
Connecticut Military Department to access my military personnel records for the purposes of evaluating this application.
Initials
STATEMENT OF CONFIDENTIALITY
This application required supporting documentation and access to your military records are the primary means of determining your eligibility to receive a
grant from the Wartime Service Bonus. Disclosure of the requested information, including the applicant’s social security number is voluntary. However,
failure to provide the requested information or access thereto may result in the inability to verify eligibility based on the lack of sufficient information.
Unverified eligibility will result in the denial and return of this application.
I attest that the information provided on this application is true and correct to the best of my knowledge.
SIGNATURE
DATE
TO BE COMPLETED BY CONNECTICUT MILITARY DEPARTMENT
APPROVED
Total Months on Active Duty NOT
served in a Combat Zone – max of 10
Total Months of Active Duty SERVED in
a Combat Zone
Total Eligible Months – max of 24
Previously Received Benefit
SIGNATURE OF CTMD VERIFICATION OFFICER
DATE
Amount of Grant
REJECTED
Reason for Ineligibility
Service was not in association with a military operation
Lack of documentation – Could not verify eligibility
Previously received maximum benefit
Not a member/former member of CTNG
Not Honorably discharged or discharged for injuries
Did not serve at least 90 consecutive days on Active Duty
sustained in the line of duty
Service was prior to September 11, 2001
Already received benefit for this period of time
Not called up as a member of a reserve component
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