Welcome! You are here to complete the forms for a Surviving Spouse of a Veteran. Here we will guide you step by step through the process of completing the needed forms for your situation.
Please be sure to complete each individual step before mailing to the VA.
Note: Interactive Forms may be downloaded at www.va.gov. Please print out and manually complete non-interactive forms. Thank you.
Steps to Complete
- Cover Letter
- Instructions to Establishing an Intent to File
- 21-0966 (Intent to File)
- Tips for Staying Sane
- Final Checklist
- Supporting Document Checklist for Surviving Spouse’s Claim
- Form 180 (Request Pertaining to Military Records)
- 21p-534EZ (Application for DIC, Death Pension, and/or Accrued Benefits)
- 21-4138 (Statement in Support of Claim)
- 21-0845 (Authorization to Disclose Personal Information to a Third Party)
- Letter Regarding Information to send to Veterans Angels, Inc.
- Disclosure Page, 21-22a (Appointment of Individual as Claimant’s Representative)
- Confidential Information
- Contact Information Page, Donation Information.
- 21-4142 (Authorization to Disclose Information to VA)
- 21-4142a (General Release for Medical Provider Information to the VA)
- Letter to Physician
- 21-2680(Examination for Housebound Status or Permanent Need for Regular Aid and Attendance)
- 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance, Skilled or Intermediate Nursing Facilities Only).
- Care Expense Statement, (Assisted Living, Group Home and other types of care)
- 21p-8416 (Medical Expense Report)
If you need any assistance in completing the required steps, feel free to call us toll-free at 1 (888) 319-1117