Claim Info


DAV Member    
Must be Numeric!



Veteran Info



Must be Numeric!







Must be Numeric!

Form Selection

   DAV Contact Brief
   Standard Form 180 Request Pertaining to Military Records
   VA Form 10-0485 Request Authorization to Release Health Info to Exchanges
   VA Form 10182 Descision Review Request: Board Appeal (Notice of Disagreement)
   VA Form 10-10EZ Application for Health Benefits
   VA Form 10-7959a CHAMPVA Claim Form
   VA Form 20-0995 Decision Review Reqeust: Supplemental Claim
   VA Form 20-0996 Decision Review Reqeust: Higher-Level Review
   VA Form 20-572 Address/Direct Deposit
   VA Form 40-0247 Presidential Memorial Certificate Request
   VA Form 40-1330 Headstone
   VA Form 40-1330M Medallion
   VA Form 21-22
   VA Form 21-526EZ Application for Disability Compensation
   VA Form 21P-527EZ Application for Pension
   VA Form 21-686c Application Request to Add and/or Remove Dependants
   VA Form 21-0779
   VA Form 21-0781 Statement in Support of Claim for Service Connection for PTSD
   VA Form 21-0781a Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault
   VA Form 21-0845
   VA Form 21-0966 Claim for Compensation/Pension
   VA Form 21-2680 Exam for Housebound Status
   VA Form 21-4138
   VA Form 21-4142 Authorization to Disclose Information to VA
   VA Form 21-4142a Release for Medical Provider Information to VA
   VA Form 21-4192 Request for Employment Information in Connection with Claim for Disablity Benefits
   VA Form 21-8940 Unemployability
   VA Form 21p-534EZ Notice to Survivor of Evidence Necessary to Substantiate a Claim for Dependency
   VA Form 21p-530 Application for Burial Benefits