Va form 21 0966-2026

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4.8 out of 5

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The document is a VA Form 21-0966, titled 'Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC.' It serves to notify the Department of Veterans Affairs (VA) of an individual's intent to file for various benefits. The form requires personal information about the claimant and veteran, including identification details and the specific benefits being sought. It emphasizes that this form is not a claim itself but a preliminary step to establish an effective date for benefits if followed by a complete application within one year.

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Click ‘Get Form’ to open VA Form 21-0966 in the editor.
Begin with Section I: Claimant/Veteran Identification. Fill in your name, Social Security number, and VA file number if applicable. Ensure all information is legible.
Continue by entering the veteran's date of birth, name, and Social Security number. Select the veteran's sex and provide their service number if available.
Complete the current mailing address section accurately, including city, state, and ZIP code. Indicate whether the veteran has previously filed a claim with VA.
In Section II: General Benefit Election, check all applicable benefits you intend to file for—Compensation, Pension, or Survivors Pension/DIC.
Finally, sign and date the form in Section III: Declaration of Intent. If applicable, include the name of your attorney or representative.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (39 Votes)
2017	4.3 Satisfied (120 Votes)

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intent to file va form

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