M21-1MR, Part II, Chapter 8
Chapter 8. Reference Information
1. VA Forms
Introduction
/ This topic contains information VA forms, including- the web site for government forms, and
- the recommended forms for stocking.
Change Date
/ December 17, 2008a. Web Site for Government Forms
/ Most of the forms listed in this topic can be retrieved and printed from the following web site:Those forms that cannot be found on the web site may be procured from normal stocking points.
b. Recommended Forms for Stocking
/ The following forms are recommended for stocking:Form Number / Form Name / Revision Date
Veterans Health Administration
10-10D / Application for CHAMPVA Benefits / 06/2005
10-10EZ / Application for Health Benefits / 07/2008
10-1394 / Application for Adaptive Equipment – Motor Vehicle / 02/2007
10-8678 / Application for Annual Clothing Allowance / 07/2006
Continued on next page
1. VA Forms, Continued
b. Recommended Forms for Stocking(continued)Veterans Benefits Administration
20-572 / Request for Change of Address/ Cancellation of Direct Deposit / 03/1996
Compensation and Pension
21-22 / Appointment of Veterans Service Organization as Claimant’s Representative / 11/2005
21-22a / Appointment of Individual as Claimant’s Representative / 05/2007
21-526 / Veteran’s Application for Compensation or Pension / 01/2004
21-527 / Income Net Worth and Employment Statement / 06/2004
21-530 / Application for Burial Benefits / 06/2002
21-534 / Application for Dependency and Indemnity Compensation Death Pension and Accrued Benefits by Surviving Spouse / 06/2005
21-535 / Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits & Death Compensation) / 04/2005
21-601 / Application for Reimbursement From Accrued Amounts Due a Deceased Beneficiary / 05/2005
21-674 / Request for Approval of School Attendance / 07/2005
21-686c / Declaration of Status of Dependents / 11/2004
21-0516 / Improved Pension Eligibility Verification Report Veterans with Spouse / 06/2004
21-0516-1 / Improved Pension Eligibility Verification Report Veterans with No Children / 06/2004
21-0517 / Improved Pension Eligibility Verification Report Veterans with Children / 06/2004
21-0518 / Improved Pension Eligibility Verification Report Surviving Spouse with No Children / 06/2004
21-0519 / Improved Pension Eligibility Verification Report Surviving Spouse with Children / 06/2004
21-2008 / Application for U.S. Flag for Burial Purposes / 09/2005
21-4138 / Statement in Support of Claim / 08/2004
Continued on next page
1. VA Forms, Continued
b. Recommended Forms for Stocking(continued)21-4142 / Authorization for Release of Information to the Department of Veterans Affairs / 05/2004
21-4502 / Application for Automobile or Other Conveyance and Adaptive Equipment / 03/2005
21-8416 / Request for Information Concerning Medical/Legal or Other Expenses / 11/2004
21-8940 / Veteran’s Application for Increased Compensation Based Upon Unemployment / 10/2004
Education
22-1990 / Application for Education Benefits / 02/2008
22-1995 / Request for Change of Program or Place of Training / 12/2005
22-1999 / Enrollment Certification / 06/2004
22-5281 / Application for Refund of Education Contributions / 07/2007
22-5490 / Application for Survivors and Dependents Educational Assistance / 11/2005
Loan Guaranty
26-1817 / Request for Determination of Loan Guaranty Eligibility – Unmarried Surviving Spouses / 11/2007
26-1880 / Request for a Certificate of Eligibility for VA Home Loan Benefits / 04/2008
26-4555 / Veterans Application for Acquiring Specially Adapted Housing or Special Home Adaptation Grant / 10/2005
Continued on next page
1. VA Forms, Continued
b. Recommended Forms for Stocking(continued)Vocational Rehabilitation & Employment
28-1900 / Disabled Veterans Application for Vocational Rehabilitation / 02/2008
Insurance
29-336 / Designation of Beneficiary Government Life Insurance / 12/2005
29-357 / Claim for Disability Insurance Benefits / 04/2005
29-1546 / Application for Cash Surrender Value or Policy Loan / 06/2007
29-4125 / Claim for One Sum Payment / 03/2008
29-4364 / Application for Service Disabled Veterans Life Insurance / 12/2003
SGLV 8714 / Application for Veterans’ Group Life Insurance / 09/2005
SGLV 8721 / Beneficiary Designation Form / 08/1996
SGLV 8283 / Claim for Death Benefits / 07/1994
National Cemetery Administration
40-1330 / Application for Standard Government Monument / 05/2008
Miscellaneous
SF 180 / Request Pertaining to Military Records / 10/2005
DD 149 / Application for Correction of Military or Naval Record / 05/2005
DD 293 / Application for the Review of Discharge of Dismissal From the Armed Forces of the U.S. / 03/2004
DD 1172 / Application for Uniformed Services Identification and Privilege Card / 09/2005
IB-10-164 / A Summary of VA Benefits for National Guard and Reserve Personnel / 03/2004
2. VA Publications and Pamphlets
Change Date
/ December 17, 2008a. Recommended Publications and Pamphlets
/ The following publications and pamphlets should be available for distribution to visitors:Number / Name / Revision Date
Compensation and Pension
21-00-1 / A Summary of VA Benefits / 04/2008
21-03-1 / VA Benefits for Survivors / 01/2006
80-08-01 / Federal Benefits for Veterans and Dependents / 2008
Education
22-05-1 / Reserve Educational Assistance Program (REAP) – Chapter 1607 / 12/2005
22-79-1 / Summary of Educational Benefits Under the Post Vietnam Era Vet Educational Assistance Program / 02/2004
22-90-2 / Summary of Educational Benefits Under the Montgomery GI Bill Active Duty Educational Assistance Program / 03/2007
22-90-3 / Summary of Educational Benefits Under the Montgomery GI Bill Selected Reserve Educational Assistance Program / 01/2007
Continued on next page
2. VA Publications and Pamphlets, Continued
a. Recommended Publications and Pamphlets(continued)Number / Name / Revision Date
Loan Guaranty
26-4 / VA Guaranteed Home Loans for Veterans / 02/2005
26-6 / To the Home Buying Veteran / 12/2005
26-71-1 / Q&A on Manufactured Home Loans for Veterans / 12/2005
26-91-1 / A Quick Guide for Homebuyers and Real Estate Professionals / 02/2005
Vocational Rehabilitation & Employment
28-01-1 / Vocational Rehabilitation and Employment / 07/2001
Insurance
29-9 / Service Disabled Veteran’s Insurance RH Information and Premium Rates / 03/2006
29-14 / Information About Waiver of Premiums / 05/2002
29-77-3 / Facts About Beneficiary and Options / 05/1990
3. Web-Based References
Change Date
/ December 17, 2008a. Web-Based Reference Listing
/ The following table provides a listing, including the appropriate link, to web-based reference sites:Title / Link
Compensation & Pension Service Intranet / C&P Service Intranet Home Page
Compensation & Pension Service Manual Rewrite (M21-1MR) / M21-1 Manual Rewrite - M21-1MR Main Site
Facilities Locator and Directory / Facilities Locator Home Page - Facilities Locator & Directory
Regional Office (ROs) Desk Reference / Regional Office (ROs) Desk References - Alphabetically
Publications Index (References, etc) / Publications Index (References, etc.)
Compensation & Pension Service User Guides / User Guides
Veterans Benefits Reference System (VBRS) / Veterans Benefits Reference System (VBRS)
State Benefits Reference System (SBRS) / This program is located off of the VBAPPS menu and can be installed by your local IRM if you do not have this.
Compensation & Pension Service, Direct Services Web Site / Direct Services Web Site
Public Contact Representatives (PCRs) Information – Alphabetically / Public Contact Representatives (PCRs) Information - Alphabetically
4. Writing References
Change Date
/ December 17, 2008a. Writing Reference Listing
/ The following table provides a listing, including the appropriate link, to web-based writing references:Title/Description / Link
Reader-Focused Writing (RFW) Web Site / Reader-Focused Writing
RFW Links to Writing Aids, including:
- Dictionaries
- Grammar References
- Style Guides
- Thesaurus
- General Writing Guides
VA Field Correspondence Guidelines / VA Field Correspondence Guidelines
GPO Style Manual / GPO Style Manual: Main Page
Elements of Style / Strunk's Elements of Style
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