Please Note: the notary stamp must read "QUALIFIED IN BRONX COUNTY. SALARY: Full Military Pay and Allowances, depending on rank and longevity of Soldier.The SCR will not accept a form with a signature date more than six-months old. Fill out, sign, and date VA Form 1010164 (Opt Out of Sharing Protected Health Information). Mail the signed, completed form to our ROI office. Want to find out what benefits a Bronx address offers your business? The complaint should conclude with a paragraph in which the plaintiff sets forth all the relief against the defendant that he or she is seeking from the court. The attached application MUST be typewritten and signed. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Send military acceptance letter via email, link, or fax.