DEPARTMENT OF VETERANS AFFAIRS OMB Control No 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the veteran's name in Block 1. Ensure you include the last name, first name, and middle initial for accurate identification.
3. In Block 2, input the claim file number. This is crucial for tracking your appeal.
4. Select your relationship to the veteran in Block 4. Options include Veteran, Veteran's Widow/er, Child, Parent, or Other.
5. Provide your contact information in Blocks 5 and 6. Include both home and work phone numbers as well as your complete address.
6. In Block 8, clearly outline the issues you wish to appeal. Be specific about each issue listed on your Statement of the Case.
7. Use Block 9 to explain why you believe the VA's decision was incorrect. Detail any facts or evidence that support your case.
8. Finally, sign and date the form in Blocks 11 and 12 before submitting it according to the instructions provided with your SOC.

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