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Get Va 10-0143 2020-2025
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How to fill out the VA 10-0143 online
The VA 10-0143 form is essential for grantees seeking to certify their compliance with drug-free workplace requirements. This guide provides detailed instructions on how to efficiently complete this form online, ensuring a smooth submission process.
Follow the steps to accurately complete the VA 10-0143 form online.
- Press the ‘Get Form’ button to access the VA 10-0143 form and open it in your preferred editor.
- In the section for 'Places of Performance', enter the specific site(s) for the work related to the grant. Make sure to include the street address, city, county, state, and zip code.
- Provide the 'Organization Name' in the designated field, ensuring that it matches the name associated with the grant.
- Input the 'Grant Number or Name' to identify the specific grant associated with the certification.
- Fill in the 'Name and Title of Authorized Representative,' ensuring the person listed has the authority to submit the certification.
- Input the 'Date' when the form is being completed.
- Sign the form in the 'Signature' section, which confirms that all provided information is accurate and truthful.
- Review all entered information for accuracy, then save your changes. You can choose to download, print, or share the completed form as necessary.
Complete the VA 10-0143 form online to ensure compliance with drug-free workplace requirements.
In most cases, we pay non-VA providers and pharmacies directly for care and prescriptions you receive in the community. In some cases, we may pay you back for cost of emergency prescriptions or care.
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