Form 21 686c 2009-2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the veteran's full name in Item 1A and their Social Security Number in Item 1B. If you are not the veteran, provide your name in Item 2A and your Social Security Number in Item 2B.
  3. Fill out the marital status section (Item 5) by checking the appropriate box. If married, include your spouse's date of birth in Item 5B.
  4. In Section I, detail the veteran's marriages. For each marriage, provide the date and place of marriage, names, Social Security numbers, and how each marriage was terminated.
  5. Proceed to Section II for information about the spouse's previous marriages. Repeat similar steps as Section I.
  6. In Section III, list any unmarried children. Include their names, dates of birth, Social Security numbers, and indicate if they are seriously disabled.
  7. Finally, ensure you sign and date the form in Items 17 and 18 before submitting it to a VA regional office.

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2022 4.3 Satisfied (56 Votes)
2018 4.8 Satisfied (162 Votes)
2014 4.4 Satisfied (62 Votes)
2009 4.1 Satisfied (65 Votes)
2004 4.2 Satisfied (35 Votes)
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Use VA Form 21-686c to submit a claim for additional benefits for a dependent, or to request to remove a dependent from your benefits.
How to Submit VA Form 21-686c Submit online at: va.gov. Mail it to: Department of Veteran Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547.
Use VA Form 21-0538 to verify the status of your dependents (spouse or children). We use this information to determine if youre eligible to continue receiving additional compensation based on how many dependents you have.
View or change dependents on your VA disability benefits. Add or remove dependents with VA Form 21-686C.
Are dependents and spouses eligible for VA Dental Care? In short, yes, this program for veterans does provide dental care for the spouse and dependent children of most 100% service-connected disabled veterans.