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Get VA Form 21-4138, Statement in Support of Claim. Use this VA form to submit a VA buddy statement or other statement you believe will help support your request for VA benefits.
SUPERSEDES VA FORM 21-4138, JUN 2021. Page 1. 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: https://ask.va.gov/, or call us . toll-free at 1-800-827-1000 (TTY:711). VA forms are available at www.va ...
21-4138. SUPERSEDES VA FORM 21-4138, JUN 2021. Page 1. VETERAN'S SOCIAL SECURITY NO. SECTION II: REMARKS (Continued) (The following statement is made in connection with a claim for benefits in the case of the above-named veteran/beneficiary) SECTION III: DECLARATION OF INTENT.
EXISTING STOCKS OF VA FORM 21-4138, JAN 2015, WILL BE USED. Page 1. INSTRUCTIONS: Read the Privacy Act and Respondent Burden on Page 2 before completing the form. Complete as much of Section I as possible. The information requested will help process your claim for benefits. If you need any additional room, use the second page. VA DATE STAMP
DEC 2017. EXISTING STOCKS OF VA FORM 21-4138, JAN 2015, WILL BE USED. Page 1. VETERAN'S SOCIAL SECURITY NO. SECTION II: REMARKS (Continued) (The following statement is made in connection with a claim for benefits in the case of the above-named veteran/beneficiary.) SECTION III: DECLARATION OF INTENT.
Please print the information request in ink, neatly, and legibly to help process the form. VA FORM 21-4138, DEC 2017 PRIVACY ACT INFORMATION: The VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38,
(Type or print) The following statement is made in connection with a claim for benefits in the case of the above-named veteran: I CERTIFY THAT the statements on this form are true and correct to the best of my knowledge and belief.
View, download and print fillable Va 21-4138 - Statement In Support Of Claim in PDF format online. Browse 2 Va Form 21-4138 Templates collected for any of your needs.
When you’re filing a claim for disability compensation from the VA, one of the forms you can include in your claim is VA Form 21-4138. This form is also known as the Statement in Support of Claim. While it’s not a required form in a VA disability claim, VA 21-4138 can be an extremely useful form.
Use this form to submit a statement to support a claim. For more information you can contact us through Ask VA: https://ask.va.gov/, or call us toll-free at 800-827-1000 (TTY:711). VA forms are available at www.va.gov/vaforms.