Home
Forms Library
Va form 21 4138 aug 2004

2004 va form 21 4138-2025

va form 21 4138 aug 2004 Preview on Page 1

Show details

4.1 out of 5

49 votes

The document is a VA Form 21-4138, used to support claims for benefits by veterans. It outlines the Privacy Act information regarding the collection and use of personal data, including Social Security numbers, and emphasizes the confidentiality of submitted information. The form requires the veteran's personal details and a certification of truthfulness in the provided statements. It also mentions potential penalties for false submissions and provides instructions for completing the form.

Here's how it works

01. Edit your va form 21 4138 aug 2004 online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

The best way to modify 2004 va form 21 4138 online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your paperwork takes just a few simple clicks. Follow these fast steps to modify the PDF 2004 va form 21 4138 online for free:

Sign up and log in to your account. Log in to the editor with your credentials or click on Create free account to test the tool’s capabilities.
Add the 2004 va form 21 4138 for editing. Click the New Document option above, then drag and drop the file to the upload area, import it from the cloud, or via a link.
Modify your document. Make any changes needed: add text and images to your 2004 va form 21 4138, underline information that matters, erase parts of content and replace them with new ones, and insert symbols, checkmarks, and fields for filling out.
Complete redacting the form. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is very user-friendly and effective. Try it now!

See more 2004 va form 21 4138 versions

We've got more versions of the 2004 va form 21 4138 form. Select the right 2004 va form 21 4138 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (91 Votes)
2017	4.4 Satisfied (135 Votes)
2011	4.4 Satisfied (632 Votes)
2004	4.1 Satisfied (49 Votes)
2000	3.9 Satisfied (33 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I write a VA statement for sleep apnea?

These statements should detail the symptoms they observed, such as loud snoring, breathing pauses, or gasping for air. Include statements like these in your claim to provide compelling evidence of sleep apnea during your military service.

What to say on VA Form 21 4138?

If the statement is more focused on the veterans symptoms, the statement should include information regarding how the veterans condition affects them, what the person writing the statement has witnessed, how the veteran has changed since service, and any other relevant details.

What is an example of a PTSD buddy statement?

[Insert Veterans Name]s PTSD symptoms have persisted, and he still experiences symptoms today. I believe that his post-traumatic stress disorder resulted from the mental stress of combat and active duty. I certify that the statements on this form are true and correct to the best of my knowledge and belief.

What is an example of a PTSD stressor statement?

Provide specific examples of your PTSD symptoms, such as I had a panic attack when I heard a car backfire, I thought it was gunfire, or I heard someone scream on TV and I ran for cover. This will be much more effective than providing clinical descriptions of symptoms that you may have learned while undergoing

What to write on VA form 21 4138?

A Statement in Support of Claim will ask for your full name, Social Security number, birth date, contact information, and VA file number. Include your service details. Include your military branch, enlistment dates, and any deployments. Outline your disability.

How do you write a powerful VA statement in support of a claim?

Shows the Impact: Explain how your disability impacts your life beyond just medical symptoms. Discuss day-to-day life, changes in your routines, challenges in physical and mental wellbeing, how it impacts your social relationships, etc. Its important to really emphasize to the VA how your life has been affected.

Is VA Form 21 4138 still valid?

SUPERSEDES VA FORM 21-4138, JUN 2021. Before completing this form, read the Privacy Act and Respondent Burden on page 2. Use this form to submit a statement to support a claim. For more information you can contact us through Ask VA: , or call us toll-free at 1-800-827-1000 (TTY:711).

What is a VA form 21 4142 used for?

Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.

2004 va form 21 4138-2025

Here's how it works