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VMLRP Service Verification Form (NIFA-09-10)

Loan payments are disbursed each quarter for the work hours completed based on the information, descriptions, and activities within the participant’s shortage nomination, as certified on the VMLRP Service Verification Form NIFA-09-10. The loan payments are only disbursed based on the executed hours. 

The participant’s employer or participant, if self-employed, will receive each quarter’s VMLRP Service Verification forms (NIFA-09-10) for the entire contract period prior to their first quarter. By completing and signing this form the employer certifies the participant is still employed by them and that the services the participant provided for the quarter are consistent with those described in the Veterinarian Shortage Situation Nomination Form (NIFA 2009-0001).

Instructions

Section 1 - This section is completed by VMLRP staff. The quarterly service verifications are provided to the participant prior to the end of the first quarter for the entire contract period. Each form will indicate the quarterly service period.

Section 2 - The supervisor or participant will review the shortage nomination before answering the two questions on the form. Indicate yes or no for each question.

Section 3 - The supervisor or participant will certify the information is correct by providing the printed name, signature, phone number, email address, and date.
 

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