Va Form 21 0966 Pdf
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Over the phone or in person. This form is used to notify va of your intent to file for the general benefit(s). Before completing this form, read the privacy act and respondent burden on page 2. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive. Web search.
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Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive. Department of veterans affairs claims intake center po box 4444 janesville,. Web intent to file a claim for compensation and/or pension, or survivors pension and/or dic instructions: Claimant's social security number omb control no. This form is used.
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Department of veterans affairs claims intake center po box 4444 janesville,. Claimant's social security number omb control no. Veteran's date of birth (mm,dd,yyyy) male 2. For more information, contact us online through ask va:.
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