VA Forms and Titles (.pdf)

(Frequently used forms are in bold print)

Form No.                        Medical Forms

10-10d                            ChampVA Application

10-10 EC                         Long-Term Care

10-10EZ                          Medical System

10-10EZR                        Means Test

10-0103                           Home and Structural Modifications

10-0411                           VA Transitional Pharmacy

10-0426                           ChampVA Meds by Mail Order

10-583                             Claim for Payment of Unauthorized Medical Services

10-1394                           Motor Vehicle Adaptive Equipment

10-7959C                         ChampVA OHI (Other Health insurance) Certification

10-8678                           Clothing Allowance

Form No.                         General VA Administrative Forms

20-572                             Request for Change of Address/Cancellation of Direct Deposit

20-5655                           Financial Status Report

Form No.                         Compensation and Pension Forms

21-22                               Appointment of Veterans Service Organization as Claimant Representative

21-22a                             Appointment of Individual as Claimant Representative

21-0304                           Application for Spina Bifida Benefits

21-0510                           Eligibility Verification Report Instructions

21-0514-1                        Parents DIC Eligibility Verification Report

21-0845                           Authorization to Disclose Personal Information to a Third Party (Fillable) NEW

21-526                             Veterans Application for Compensation or Pension (Fillable) NEW

21-526EZ                         FULLY DEVELOPED CLAIM (Compensation) (Fillable) NEW

21-526b                           Veteran's Supplemental Claim for Compensation (Fillable) NEW

21-526c                           Pre-Discharge Compensation Claim (Fillable) NEW

21-527                             Income, Net Worth and Employment Statement

21-530                             Application for Burial Benefits

21-534                             Application for DIC, Spouse’s Pension and Accrued Benefits

21-535                             Application for DIC for Parent

21-601                             Application for Reimbursement from Accrued Amount Due to Deceased Beneficiary

21-674                             Request for Approval of School Attendance

21-686c                           Declaration of Status of Dependents

21-2008                           Application for Burial Flag

21-4138                           Statement in Support of Claim

21-4142                           Release of Information to the VA, Authorization and Consent

21-4502                           Application for Automobile Adaptive Equipment

21-4703                           Fiduciary Agreement

21-6753                           Original or Amended DIC Award

21-8416                           Medical Expense Report

21-8678                           Application for Annual Clothing Allowance

21-8940                           Application for Increased Compensation Based on Unemployability

21-8951-2                        Waiver of VA Compensation or Pension to Receive Military Pay                                   

Form No.                         Finance and Budget Forms

24-0296                           Direct Deposit Enrollment

24-5281                           Application for Refund of Education Contribution

Form No.                         Insurance Forms

29-336                             Designation of Beneficiary – Government Life Insurance

29-1546                           Application for Cash Surrender Value/Policy Loan

29-4125                           Claim for One Sum Payment - Government Life Insurance

29-4364                           Application for Service-Disabled Insurance

Form No.                         Education Forms

22-1990                           Application for VA Education Benefits

22-1990t                          Application/Enrollment Certification for Individualized Tutorial Assistance

22-1995                           Request for Change of Program or Place of Training

22-1999c                         Certification of Affirmation of Enrollment Agreement – Correspondence Course

22-5490                           Application for Survivor’s and Dependents Educational Assistance

22-5495                           Request for Change of Program or Place of Training - Survivor’s and Dependents Educational Assistance

22-6553c                         Monthly Certification of Flight Training

22-8690                           Time Record (Work Study Program)

22-8691                           Application for Work Study Allowance

22-8873                           Supp. Info for Change of Program or Re-Enrollment After Unsatisfactory Attendance or Progress

Form No.                         Loan Guarantee Forms

26-0286                           VA Loan Summary Sheet

26-0503                           Federal Collection Policy Notice

26-0592                           Counseling Checklist for Military Home Buyers

26-1802a                         HUD/VA Addendum to Uniform Residential Loan Application

26-1814                           Batch Transmittal – Loan Code Sheet

26-1817                           Request for Determination of VA Guarantee Eligibility – Unremarried Surviving Spouse

26-1820                           Report and Certification of Loan Disbursement

26-1839                           Compliance Inspection Report

26-1844                           Request for Acceptance of Changes in Approved Drawings/Specs

26-1847                           Request for Postponement of Offsite or Onsite Exterior Improvements

26-1852                           Description of Materials

26-1880                           Request for Certificate of Eligibility for VA Home Loan Benefit

26-6382                           Statement of Purchasers or Owner Assuming Sellers Loan

26-6393                           Loan Analysis

26-6681                           Fee or Roster Designation – Appl for Fee Personnel Designation

26-6684                           Statement of Fees – Appraisers or Compliance Inspectors

26-6705                           Offer to Purchase and Contract of Sales

26-6705b                         Credit Statement of Prospective Purchaser

26-6807                           Financial Statement

26-8630                           Manufactured Home Loan Claim Under Loan Guaranty

26-8712                           Manufactured Home Appraisal Report

26-8736                           Appl For Authority to Close Loans on an Automatic Basis – Non-Supervised Lenders

26-8736a                         Non-Supervised Lenders Nomination & Recommendation of Credit Underwriter

26-8791                           VA Affirmative Marketing Certification

26-8812                           VA Equal Opportunity Lender Certification

26-8937                           Verification of VA Benefit-Related Indebtedness

Form No.                         Voc-Rehab and Employment Forms

28-1900                           Disabled Veteran’s Application for Vocational Rehabilitation

28-1902                           Counseling Record – Personal Information

28-1902n                         Counseling Record – Narrative Report

28-8872                           Rehabilitation Plan

28-8872a                         Rehabilitation Plan – Continuation Sheet

28-8890                           Important Information about Rehabilitation Benefits

Form No.                         Other Forms Used By The VA and Other Agencies

DD 149                             Application for Correction of Military Records

DD 293                             Application for the Review of Discharge or Dismissal from the Armed Forces

SF 15                               Application for 10-Point Veteran’s Preference

SF 180                             Request Pertaining to Military Records

SGLV 8283                      Claim for Death Benefits – Form Returned to Office of Service Group Life Insurance

SGLV 8285                      Request for Insurance – Service Group Life Insurance

SGLV 8286                      Service Group Life Insurance Election and Certificate

SGLV 8714                      Application for Veterans Group Life Insurance

VA8                                Certification of Appeal

VA9                                Appeal to Board of Appeals

VA-3288                          Request for and Consent to Release of Information from Claimant’s Records

VA4107                           Notice of Procedural and Appellate Rights

40-0247                           Presidential Memorial Certificate Request Form

40-1330                           Application for Headstone/Marker at Private Cemetery