Attorneys

Dependants and Survivors Forms

• Eligibility Verification Report (Surviving Spouse)
  If you are a surviving spouse of a Veteran and are receiving a Veteran's Administration Section 306 or Old Law pension (pre-1960) use this form to submit your annual eligibility verification. (2900-0101)
• Information Regarding Apportionment of Beneficiary's Award
  Submit this form if you are the surviving spouse, child or dependent parent of a deceased veteran to claim the veteran's disability award. (21-0788)
• Dependency and Indemnity Compensation by Parent(s)
  Submit this form if you are a deceased veteran's surviving parent. You may be entitled to any benefits or money the Veteran's Administration owes your child. (21-535)
• Request for Approval of School Attendance
  This form is for children of veterans who are between 18-23 years of age and who are entitled to Veteran's Administration benefits through their parent. Submit this form to request the VA pay your school tuition. (21-674)
• Award Attachment for Certain Children with Disabilities Born of Vietnam Veterans
  Children who were born with birth defects caused by the Vietnam or Korean wars are entitled to health care paid for by the Veteran's Administration. This form gives information on how to apply for that coverage. (21-0307)
• Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korean Service Veterans
  Children who were born with birth defects caused by the Vietnam or Korean wars are entitled to health care paid for by the Veteran's Administration. Use this form to apply for that coverage. (21-0304)
• Information From Remarried Widow/er
  If you have been receiving a pension because you are a surviving spouse of a veteran, you may no longer be eligible for the Veteran's Administration pension if you remarry. Submit this form for the VA to determine your continuing eligibility. (21-4103)
• Application of Surviving Spouse or Child for REPS Benefits
  If you are a surviving spouse or child of a veteran who died prior to August 13, 1981 submit this form to determine your eligibility to receive a Veteran's Administration REPS pension. (21-8924)
• Statement of Marital Relationship
  Submit this form to the VA to help them determine eligibility for additional benefits as a spouse of a veteran or the surviving spouse of a veteran. (VA FORM OCT 2004 21-4170)
• Supporting Statement Regarding Marriage
  The VA uses this information to determine eligibility for benefits based on a marital relationship between you and the veteran. (VA FORM NOV 2004 21-4171)