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Click ‘Get Form’ to open the VA Form 21-0304 in the editor.
Begin with Section I: Child's Identification Information. Fill in the child's name, date of birth, social security number, place of birth, telephone number, and mailing address. Ensure all information is accurate for smooth processing.
Proceed to Section II: Relationship with Parents. Provide details for both natural parents including names, addresses, telephone numbers, and veteran status. If applicable, include information about custodians or guardians.
In Section III: Claim Information, list any disabilities claimed along with the name and place of diagnosis. Include your primary health care provider's details and recent treatment information.
Complete Section IV: Direct Deposit Information if you wish to receive payments electronically. Attach a voided check or deposit slip as required.
Finally, sign and date the form in Section V: Claim Certifications and Signatures. Ensure that all signatures are completed as per instructions before submitting.
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Jun 2, 2026 Apply for VA health care, find out how to access services, and manage your health and benefits online. Disability. File a claim for disabilityRead more
Federal Benefits for Veterans, Dependents Survivors and
You can also chat online with VA staff in most participating locations Monday to Friday, 8 a.m. to 4 p.m. local time, excluding federal holidays. In someRead more
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