The first step in
submitting an application for a Veteran's Pension or Spouse/Child Death Benefit is to attain the Service Records of the Veteran.
National Archives Service Records Electronic Request
Or Submit Paper Request
PDF Standard Form 180 Request of Service Records
Appointment of Representative
Individual, Service Organization Or Family Member
VBA-21-22A Appointment of Individual as Claimant's Representative
Appointment of Service Organization
The Third Party Authorization form is need to be completed for all individuals
or service organizations to attain records of the veteran. This includes individuals/family members assisting in preparing
the application for pension benefits.
VA 21-0845 Authorization (For the VA) to Disclose Personal Information to a Third Party
This Form is necessary to be completed for all parties providing services to the Veteran,
Spouse/Child in order to release information to the VA as part of the application.
VA Form 21-4142 Authorization and Consent to Release Information to the Department of Veterans Affairs
This form establishes the financial need for assistance and ultimately
the amount of assistance. There is no net worth limited specified however the general guidance is that between $70,000
to $80,000 in net worth (EXCLUDING the Veteran/Spouse primary residence and automobile).
VBA-21-527 Income - Net worth and Employment Statement
File Completed Applications with
one of the following three Service Centers based on Claimant's Residence.
Milwaukee Pension Maintenance Center
5400 West National Avenue
Milwaukee, WI 53214
Processes claims for the following states:
AL, AR, IL, IN, KY, LA, MI, MO, MS, OH, TN, WI
St. Paul Pension Maintenance Center
Federal Drive, Fort Snelling
Paul, MN 55111-4050
claims for the following states:
AZ, CA, CO, HI, IA, ID, KS, MN, MT, ND, NE, NV, OK, OR, SD, TX, UT, WA, WY
Philadelphia Pension Maintenance Center
5000 Wissahickon Avenue
Processes claims for
the following states:
DE, FL, GA, MA, MD, ME, NC, NH, NJ, NY, PA, PR, RI, SC, VA, VT, WV
Form to be completed by Assisted Living Facility, Nursing Home and/or
Form 21-0779 establishes the need for Aid and Attendance (Pension payments greater
than Base Pension). This form should be completed by the Nursing Home or Assisted Living facility and submitted with
the application for Pension.
VA-21-0779 Request for Nursing Home Information in Connection with Claim for Aid and Attendance
Statement of Attending Physician
Click on eBenfits Logo below to complete form online. We
suggest that you complete a paper copy prior to entering information on line. If you need assistance in completing the
forms contact the VAAC for a member service provider in your area.
Click here to link to the Submit Application through www.ebenefits.va.gov
Other Needed Forms
Certification No Fees Paid
Certification of Recurring Medical Services
Certification of Recurring Medical Expenses
Certification of Fully Developed Claim
It is recomend that
applications be sent via Federal Express or UPS/USPS return receipt requested to be assured that application was submitted,
received and establishes the date of the application. Approval of applications may take a year or more but pension benefits
are paid retro-actively from date of the application establishing the date the application was submitted is important.