va form 21p-534 · supersedes va form 21-534, jun 2018, which will not be used. for application for...

If you have any questions about this form how to fill it out or about VA benefits contact your nearest VA regional office You can locate the address of the nearest regional office in your telephone book blue pages under United States Government Veterans or call 1-800-827-1000 (Hearing Impaired TDD line is 711) You may also contact VA by Internet at httpsiriscusthelpcom

GENERAL INSTRUCTIONS

Note Read very carefully detach and keep these instructions for your reference

A How can I contact VA if I have questions

B What is the purpose of VA Form 21P-534Use VA Form 21P-534 to apply for VA benefits you may be entitled to receive as a surviving spouse or child of a deceased veteran and any money VA owes the veteran but did not pay prior to his or her death (accrued benefits) NOTE If you apply for any one of these benefits the law requires that we also consider you for the others

C What is the purpose of the attached SSA-24 formYou can apply for Social Security (SS) benefits by using the SSA-24 form attached to this VA Form (see pages 12 and 13) You dont have to apply if you dont want to or have already done so If you do want to apply fill it out and leave it attached We will send it to the Social Security Administration for you They will then contact you

D What are dependency and indemnity compensation (DIC) and Survivors Pension benefits and how does VA decide what I will or will not receive1 Dependency and indemnity compensation may be payable when a veterans death occurred while on active service or a veteran dies of a service-connected disability or disabilities that waswere either the principal or contributory cause of death or a veteran died from a non-service connected injury or disease AND was receiving or entitled to receive VA compensation for a service- connected disability rated totally disabling For at least 10 years immediately before death or For at least 5 years after the veterans release from active duty preceding death or For at least 1 year before death if the veteran was a former prisoner of war who died after September 30 1999 2 Survivors Pension may be payable when the death of a veteran with wartime service is not due to service and income and assets are within applicable limits VA pays pension based on the amount of family income and assets and the number of dependent children This is based on law VA must include as income all sources that Federal law specifies If there is no surviving spouse pension may be payable on behalf of a child or children You must provide information about the Social Security benefits you and your dependents receive Report the gross amount you and your dependents receive monthly before deductions are taken out If you have a copy of your most recent Social Security award letter please include a copy of the letter with your application You must tell us if you or your dependents receive or received income from sources other than Social Security Please also report if you or your dependents own your primary residence and the value of your assets and your dependents assets Your assets do include your spouses assets Although your assets do not include your childs assets you must tell us if your child has significant assets Assets means the fair market value of all property that an individual owns including all real and personal property (excluding the value of the primary residence including the residential lot area not to exceed 2 acres) less the amount of mortgages or other encombrances specific to the mortgaged or encumbered property) Personal property means the value of personal effects that are in excess of being suitable and consistent with a reasonable mode of life Unless a claim for dependency and indemnity compensation or Survivors Pension is filed within 1 year from the date of the veterans death that benefit is not payable from a date earlier than the date the claim is received in the VA If it is determined that you are entitled to DIC and death pension we will pay you whichever benefit entitles you to the most money Benefit rates and income limits are frequently changed so it is not possible to keep this information current in these instructions You can find out what the current income limitations and rates of benefits are by contacting your nearest VA regional office

VA FORM OCT 2018

21P-534 SUPERSEDES VA FORM 21-534 JUN 2018 WHICH WILL NOT BE USED

FOR APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION (DIC) SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (INCLUDING DEATH COMPENSATION IF APPLICABLE)

VA FORM 21P-534

PAGE 1General Instructions

H How can I assign someone to act as my representative

I What if I believe that VA has made an error in processing or deciding my benefits

G What do I do when I have completed my application

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 Code of Federal Regulations 1576 for routine uses (ie civil or criminal law enforcement congressional communications epidemiological or research studies the collection of money owed to the United States litigation in which the United States is a party or has an interest the administration of VA programs and delivery of VA benefits verification of identity and status and personnel administration) as identified in the VA system of records 58VA212228 Compensation Pension Education Vocational Rehabilitation and Employment Records - VA published in the Federal Register Your obligation to respond is required to obtain or retain benefits Giving us your SSN account information is mandatory Applicants are required to provide their SSN under Title 38 USC 5101 (c) (1) The VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by Federal Statute of law in effect prior to January 1 1975 and still in effect The requested information is considered relevant and necessary to determine maximum benefits under the law The responses you submit are considered confidential (38 USC 5701) Information that you furnish may be utilized in computer matching programs with other Federal or state agencies for the purpose of determining your eligibility to receive VA benefits as well as to collect any amount owed to the United States by virtue of your participation in any benefit program administered by the Department of Veterans Affairs

RESPONDENT BURDEN We need this information to determine eligibility for death benefits and accrued benefits under 38 USC 1310 through 1314 1532 through 1543 and 5121 Title 38 United States Code allows us to ask for this information We estimate that you will need an average of 1 hour and 15 minutes to review the instructions find the information and complete this form VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed You are not required to respond to a collection of information if this number is not displayed Valid OMB control numbers can be located on the OMB Internet Page at wwwreginfogovpublicdoPRAMain If desired you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form

General Instructions

A representative can be a VA accredited Veterans Service Organization or other service organization that the Secretary of Veterans Affairs recognizes or a VA accredited attorney or claims agent Agents and attorneys can charge you for services that you get from them only after the Board of Veterans Appeals (BVA) gives you their final decision about your application That means you can use an attorney during any stage of your application for benefits However the agent or attorney cannot charge you for services unless you are trying to resolve a dispute with VA after BVA has made a decision about your claim If you want to use a representative to help you with your application contact the nearest VA office Depending on the type of representative you want to designate we will send you one of the following forms bull VA Form 21-22 Appointment of a Veterans Service Organization as Claimants Representative or bull VA Form 21-22A Appointment of Individual as Claimants Representative You may also download these forms at wwwvagovvaforms If you have already designated a representative no further action is required on your part

When you have completed this application mail it or take it to a VA regional office Be sure to attach any materials that support and explain your claim Also make a photocopy of your application and everything that you submit to VA before mailing it You can find the mailing address of your local VA regional office at wwwvagovdirectory

You can ask for a personal hearing at any time during the processing of your claim That means you can ask for the hearing while VA is processing your claim or after VA has made a decision You should contact the nearest VA office and tell them that you want a personal hearing on your case Someone in the local VA office will arrange a time and place for your hearing At this hearing you can bring witnesses VA will record whatever you and your witnesses say during the hearing and include it in the official record VA will furnish the hearing room and officials and prepare a transcript of the hearing VA cannot pay your expenses or the expenses of anyone you want to bring with you to the hearing

PAGE 2VA FORM 21P-534 OCT 2018

IMPORTANT If you are certifying that you are married for the purpose of VA benefits your marriage must be recognized by the place where you andor your spouse resided when you filed your claim (or later date when you became eligible for benefits) (38 USC sect 103(c)) Additional guidance on VA recognized marriages is available at httpwwwvagovopamarriage

Print all answers clearly If an answer is none or 0 write that Your answer to every question is important to help us complete your claim If you do not know the answer write unknown For additional space use Item 49 Remarks or attach a separate sheet indicating the item number to which the answers apply Make sure you sign and date this application (Items 46A and 46B)

F How do I complete my application

Note If the claim is being made on behalf of a minor or incompetent person the application form should be completed and filed by the legal guardian If no legal guardian has been appointed it may be completed and filed by some person acting on behalf of the minor or incompetent person

VA may pay increased survivor benefits to a surviving spouse who is blind a patient in a nursing home due to mental or physical incapacity requires the aid of another person to perform personal functions required in everyday living such as bathing feeding dressing yourself attending to the wants of nature adjusting prosthetic devices or protecting yourself from the hazards of your daily environment (38 Code of Federal Regulations 3352(a)) or who is permanently confined to his or her immediate premises because of a permanent disability If you wish to apply for this benefit check Yes for Item 31

E How do I apply for special monthly pension or special monthly DIC

PART II - IDENTIFYING INFORMATION (Provide information about you and the deceased veteran)

DAYTIME

PART I - CLAIM INFORMATION (Tell us what you are applying for and what you and the deceased veteran have applied for)

21G GRADE RANK OR RATING

21I PLACE ENTERED ACTIVE SERVICE - First Period

21A ENTERED ACTIVE SERVICE - First Period

(Month Day Year)

18 WHAT IS YOUR E-MAIL ADDRESS

CELL PHONE

IMPORTANT - Read the attached General Instructions before you fill out this form

1 DID THE VETERAN EVER FILE A CLAIM WITH VA

EVENING

PART III - VETERANS ACTIVE DUTY SERVICE

(DO NOT WRITE IN THIS SPACE)

(VA DATE STAMP)

21H ENTERED ACTIVE SERVICE - Second Period

(Month Day Year)

21J SERVICE NUMBER

21L PLACE LEFT ACTIVE SERVICE - Second Period 21M BRANCH OF SERVICE

21F BRANCH OF SERVICE

21N GRADE RANK OR RATING

21E PLACE LEFT ACTIVE SERVICE - First Period

21D DATE LEFT ACTIVE SERVICE - First Period

(Month Day Year)

21K DATE LEFT ACTIVE SERVICE - Second Period

(Month Day Year)

3 HAS THE SURVIVING SPOUSE OR CHILD EVER FILED A CLAIM WITH VA

VA FORM OCT 2018 21P-534 PAGE 3SUPERSEDES VA FORM 21-534 JUN 2018

WHICH WILL NOT BE USED

2 WHAT IS THE VA FILE NUMBER (If known)

5 WHAT IS THE NAME OF THE PERSON ON WHOSE SERVICE THE CLAIM WAS FILED (First Middle Last Name of Veteran)

(If Yes answer Item 2)YES

15 WHAT IS YOUR RELATIONSHIP TO THE VETERAN (Check one) 16 WHAT IS YOUR ADDRESS (Number and street or rural route city or PO State ZIP Code and Country)

7 ARE YOU CLAIMING SERVICE CONNECTION FOR CAUSE OF DEATH

8 WHAT IS THE VETERANS NAME (First Middle Last Name of Veteran) (Suffix - if applicable)

(NOTE Attach a copy of the death certificate unless the veteran died in active service of the Army Navy Air Force Marine Corps or Coast Guard or in a US government institution)

21C SERVICE NUMBER

NO

11 WHAT IS THE VETERANS DATE OF BIRTH (Month Day Year)

13 WAS THE VETERAN A FORMER PRISONER OF WAR

9 VETERANS SOCIAL SECURITY NO

APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD

(Including Death Compensation if Applicable)

14 WHAT IS YOUR NAME (First Middle Last Name of Veterans Spouse or Child)

17 WHAT ARE YOUR TELEPHONE NUMBERS (Include Area Code)

(If Yes answer Items 4 through 6)YES NO4 WHAT IS THE VA FILE NUMBER (If known)

6 WHAT IS YOUR RELATIONSHIP TO THAT PERSON

YES NO

OMB Approved No 2900-0004 Respondent Burden 1 hour 15 minutes Expiration Date 10312021

10A DID THE VETERAN SERVE UNDER ANOTHER NAME

(If Yes answer Item 10B)YES NO

10B LIST THE OTHER NAME(S) THE VETERAN SERVED UNDER

12 WHAT IS THE VETERANS DATE OF DEATH (Month Day Year)

YES NO

SURVIVING SPOUSE

CHILD

19 WHAT IS YOUR SOCIAL SECURITY NUMBER 20 WHAT IS THE YOUR DATE OF BIRTH (Month Day Year)

IMPORTANT Enter complete information for all periods of service If more space is needed use Item 49 Remarks If the veteran never filed a claim with VA attach the original DD214 or a certified copy for each period of service listed We will return original documents to you

21B PLACE ENTERED ACTIVE SERVICE - First Period

PART IV - MARITAL INFORMATION (Attach a copy of your marriage certificate showing your marriage to the veteran)

PART V - DEPENDENT CHILDREN (Complete ONLY if claiming benefits for a child(ren) of the veteran) (Skip to Section VI if you are NOT claiming benefits for a child(ren) of the veteran)

26 DID YOU LIVE CONTINUOUSLY WITH THE VETERAN FROM THE DATE OF MARRIAGE TO THE DATE OF HISHER DEATH

23B HAVE YOU REMARRIED SINCE THE DEATH OF THE VETERAN 23A HOW MANY TIMES HAVE YOU BEEN MARRIED (Include your marriage to the veteran)

YES NO YES NO

23C DATE (month day year) and PLACE OF MARRIAGE (citystate or country)

22E HOW MARRIAGE TERMINATED

(death divorce)

22B DATE (month day year) and PLACE OF MARRIAGE (city state or country)

22C TO WHOM MARRIED (first middle last name)

22D TYPE OF MARRIAGE (ceremonial common-law

proxy tribal or other)

(If Yes provide explanation)___________________________________________________________________________________________

TELL US ABOUT YOUR MARRIAGES

TELL US ABOUT THE VETERANS MARRIAGES

23F HOW MARRIAGE TERMINATED

(death divorce marriage has not been terminated)

23H IF YOU INDICATED OTHER AS TYPE OF MARRIAGE IN ITEM 23E PLEASE EXPLAIN

YES NO

22A HOW MANY TIMES WAS THE VETERAN MARRIED (Include marriage to you)

23G DATE (month day year) and PLACE MARRIAGE

TERMINATED (citystate or country)

VA FORM 21P-534 OCT 2018

24 WAS A CHILD BORN TO YOU AND THE VETERAN DURING YOUR MARRIAGE OR PRIOR TO YOUR MARRIAGE

Page 4

22G IF YOU INDICATED OTHER AS TYPE OF MARRIAGE IN ITEM 22D PLEASE EXPLAIN

22F DATE (month day year) and PLACE MARRIAGE TERMINATED

(citystate or country)

25 ARE YOU EXPECTING THE BIRTH OF THE VETERANS CHILD

27 WHAT WAS THE CAUSE OF SEPARATION GIVE THE REASON DATE(S) AND DURATION OF THE SEPARATION (IF THE SEPARATION WAS BY COURT ORDER ATTACH A COPY OF THE ORDER)

28 AT THE TIME OF YOUR MARRIAGE TO THE VETERAN WERE YOU AWARE OF ANY REASON THE MARRIAGE MIGHT NOT BE LEGALLY VALID

23D TO WHOM MARRIED (first middle last name)

23E TYPE OF MARRIAGE (ceremonial common-law


(If No complete Item 27)

NO

YES NO

YESProvide information in Items 23c through 23G for all of your marriages)

(Answer Item 24 only if you were married to the veteran less than one year)

TELL US ABOUT THE UNMARRIED CHILDREN OF THE VETERAN NOTE You should provide a copy of the public record of birth or a copy of the court record of adoption for each child listed in Item 29A unless the veteran was receiving additional VA benefits for the child If you need additional space please attach a separate VA Form 21-686c Declaration of Status of Dependents providing the requested information about each child

IMPORTANT Skip to Part VI if you are not claiming benefits for any children that meet the following criteria VA recognizes the veterans biological children adopted children and stepchildren as dependents These children must be unmarried and

∙ under age 18 or at least 18 but under 23 and pursuing an approved course of education or of any age if they became permanently unable to support themselves before reaching at 18 ∙

∙Seriously disabled (Item 29H) means that the child became permanently unable to support himselfherself before reaching age 18 Furnish a statement from an attending physician or other medical evidence which shows the nature and extent of the physical or mental impairment Note to surviving spouse If entitlement to DIC is established a seriously disabled child over age 18 is entitled to receive DIC benefits in his or her own right A veterans child who is seriously disabled and over age 18 must submit a separate VA Form 21-534 to apply for benefits

NOTE You must furnish complete information about all marriages of the surviving spouse and the veteran If you need additional space please attach a separate VA Form 21-686c Declaration of Status of Dependents providing the requested information If you are claiming benefits as the surviving spouse of the veteran you should complete Items 22A through 28 If you are not the surviving spouse skip to Section V

PART VI - HOUSEBOUND IN A NURSING HOME OR REQUIRE AID AND ATTENDANCE

NOTE If you are claiming aid and attendance allowance andor housebound benefits because you need the regular assistance of another person are having severe visual problems or are housebound and not in a nursing home submit a statement from your doctor showing the extent of your disabilities If you are in a nursing home attach a statement signed by an official of the nursing home showing the date you were admitted the level of care you receive the amount you pay out-of-pocket for your care and whether Medicaid covers all or part of your nursing home costs


(If Yes answer Items 32B and 32C and submit a statement from an official of the nursing home that tells us that you are a patient in the nursing home because of a physical or mental disability The statement should include the monthly charge you are paying out-of-pocket for your care)

Page 5

31 ARE YOU CLAIMING SPECIAL MONTHLY PENSION BECAUSE YOU NEED THE REGULAR ASSISTANCE OF ANOTHER PERSON HAVE SEVERE VISUAL PROBLEMS OR ARE CONFINED TO YOUR IMMEDIATE PREMISES

32A ARE YOU NOW IN A NURSING HOME 32B PROVIDE THE NAME AND COMPLETE MAILING ADDRESS OF THE FACILITY

32C DOES MEDICAID COVER ALL OR PART OF YOUR NURSING HOME COSTS 32D HAVE YOU APPLIED FOR MEDICAID

YES NO

YES NO

YES NO (If No answer Item 32D) YES NO

Tell us about the child(ren) listed in Item 29A that do not live with you in Items 30A through 30D

29A NAME OF CHILD (First middle initial last name)

(Check all that apply) 29G

18-23 YEARS OLD (in school)

30B CHILDS COMPLETE ADDRESS (Number and street or rural route city or PO city

State ZIP Code and country)

29C SOCIAL SECURITY NUMBER

29D BIOLOGICAL

$

29H SERIOUSLY DISABLED

29F STEPCHILD

29I CHILD

MARRIED

29J CHILD PREVIOUSLY

MARRIED

29E ADOPTED


29B DATE (month day year) and PLACE OF

BIRTH (citystate or country)

30D MONTHLY AMOUNT YOU CONTRIBUTE TO THE CHILDS

SUPPORT

30C NAME OF PERSON THE CHILD LIVES WITH (If applicable)

$

$

PART V - DEPENDENT CHILDREN (Complete ONLY if claiming benefits for a child(ren) of the veteran) (Skip to Section VI if you are NOT claiming benefits for a child(ren) of the veteran) (Continued)

(If Yes please complete and attach with this application VA Form 21-2680 Exam for Housebound Status or Permanent Need for Regular Aid and Attendance Please make sure every box is complete and signed by a Physician Physician Assistance (PA) Certified Nurse Practitioner (CNP) or Clinical Nurse Specialist (CNS))

PART VII - INCOME AND ASSETS

YES

33B IS SOCIAL SECURITY BASED ON YOUR OWN EMPLOYMENT

33A HAVE YOU CLAIMED OR ARE YOU RECEIVING BENEFITS FROM THE SOCIAL SECURITY ADMINISTRATION ON YOUR OWN BEHALF OR ON BEHALF OF A CHILD OR CHILDREN IN YOUR CUSTODY

(If Yes answer Item 40B) YES NO

YES NO

34 HAS A SURVIVING SPOUSE OR CHILD FILED A CLAIM FOR COMPENSATION FROM THE OFFICE OF WORKERS COMPENSATION PROGRAMS BASED ON THE DEATH OF THE VETERAN

YES NO

35 HAS A COURT AWARDED DAMAGES BASED ON THE DEATH OF THE VETERAN OR IS A CLAIM OR LEGAL ACTION FOR DAMAGES PENDING

YES NO

36 HAVE YOU CLAIMED OR ARE YOU RECEIVING SURVIVOR BENEFIT PLAN (SBP) ANNUITY FROM A SERVICE DEPARTMENT BASED ON THE DEATH OF THE VETERAN

NO

Page 6VA Form 21P-534 OCT 2018

PART VIII - INCOME AND ASSETS

IMPORTANT Tell us about the income and assets of you and your dependents

SOCIAL SECURITY RECIPIENT GROSS MONTHLY AMOUNT

37B GROSS MONTHLY INCOME (Attach a separate sheet if necessary)

$

$

$

$

$

YES NO

38 DO YOU OWN YOUR PRIMARY RESIDENCE

(If No skip to Item 40)

Square Feet______________

IMPORTANT VA matches income information reported with Federal tax information Report ALL income you and your dependents receive on the appropriate sections of this form and VA Form 21P-0969 Income and Asset Statement if appropriate

YES NO

39A WHAT IS THE SIZE OF THE LOT ON WHICH YOUR PRIMARY RESIDENCE SITS (Square Feet)

39B COULD PART OF YOUR LOT BE SOLD WITHOUT SELLING YOUR RESIDENCE

(If YES complete and attach VA Form 21P-0969 Income and Asset Statement)

40A OTHER THAN SOCIAL SECURITY DO YOU OR YOUR DEPENDENTS RECEIVE ANY INCOME

YES NO

40B OTHER THAN SOCIAL SECURITY DID YOU OR YOUR DEPENDENTS RECEIVE ANY INCOME LAST YEAR

YES NO

40C DO YOU OR YOUR DEPENDENTS HAVE MORE THAN $10000 IN ASSETS (NOTE Assets are all the money and property you or your dependents own Assets do not include your primary residence or personal effects such as appliances and vehicles you or your dependents need for transportation)

YES NO

40D IN THE THREE CALENDAR YEARS BEFORE THIS YEAR DID YOU OR YOUR DEPENDENTS TRANSFER ANY ASSETS (Examples of asset transfers include giving them away selling them purchasing an annuity or using them to establish a trust)

YES NO

40E DID YOU ANSWER YES TO ANY OF THE QUESTIONS IN ITEMS 40A THRU 40D

YES NO (If Yes you must also complete VA Form 21P-0969 Income and Asset Statement)

PART IX - DIRECT DEPOSIT INFORMATIONThe Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT) also called direct deposit Please attach a voided personal check or deposit slip or provide the information requested below in Items 41 42 and 43 to enroll in direct deposit If you do not have a bank account you must receive your payment through Direct Express Debit MasterCard To request a Direct Express Debit MasterCard you must apply at wwwusdirectexpresscom or by telephone at 1-800-333-1795 If you elect not to enroll you must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950 They will encourage your participation in EFT and address any questions or concerns you may have

41 ACCOUNT NUMBER (Check the appropriate box and provide the account number or simply write Established if you have a direct deposit with VA)

43 ROUTING OR TRANSIT NUMBER (The first nine numbers located at the bottom left of your check)

42 NAME OF FINANCIAL INSTITUTION (Please provide the name of the bank where you want your direct deposit)

Account No__________________ Account No__________________

SAVINGSCHECKING I CERTIFY THAT I DO NOT HAVE AN ACCOUNT WITH A FINANCIAL INSTITUTION OR CERTIFIED PAYMENT AGENT

$

$

$

$

YES NO

37A DO YOU OR YOUR DEPENDENTS RECEIVE SOCIAL SECURITY BENEFITS

(If Yes complete Item 37B) (If No skip to Item 38)

PART X - MEDICAL LAST ILLNESS BURIAL OR OTHER UNREIMBURSED EXPENSES

Family medical expenses and certain other expenses actually paid by you may be deductible from your income Show the amount of any unreimbursed medical expenses including the Medicare deduction you paid over the last year (or expect to pay and continue indefinitely) for yourself or relatives who are members of your household Also show unreimbursed last illness and burial expenses and educational or vocational rehabilitation expenses you paid Last illness and burial expenses are unreimbursed amounts paid by you for the veterans or hisher childs last illness and burial and the veterans just debts Educational or vocational rehabilitation expenses are amounts paid for courses of education including tuition fees and materials Do not include any expenses for which you were reimbursed If you receive reimbursement after you have filed this claim promptly advise the VA office handling your claim If more space is needed attach a separate VA Form 21P-8416 Medical Expense Report IMPORTANT If you are claiming expenses for in-home care or assisted living adult day care or similar facility you must complete the applicable worksheet(s) on pages 10 and 11

VA FORM 21P-534 OCT 2018 Page 7

45C PURPOSE (Medicare premiums

nursing home etc)

45B PAID TO (Name of provider Insurance company nursing home etc)

45A WHOSE MEDICAL BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID (mmddyyyy)

$

$

$

$

$

$

$

$

$

$

IMPORTANT Tell us about medical last illness burial or other unreimbursed expenses

YES NO

44 ARE YOU CLAIMING UNREIMBURSED MEDICAL EXPENSES

45E HOURLY RATEHOURS

(In-home Provider only)

$

$

PART XI - CERTIFICATION AND SIGNATURE

I CERTIFY AND AUTHORIZE the release of information

I CERTIFY that the statements in this document are true and complete to the best of my knowledge I authorize any person or entity

including but not limited to any organization service provider employer or government agency to give the Department of Veterans Affairs

any information about me and I waive any privilege which makes the information confidential

46A SIGNATURE (Provide your signature in the box DO NOT PRINT) (If you sign with an X then you must have 2 people you know witness as you sign They must then sign the form and print their names and addresses)

46B TODAYS DATE (MMDDYYYY)

47A SIGNATURE OF WITNESS (If claimant signed above using an X)


47B PRINTED NAME AND ADDRESS OF WITNESS


(If No skip to Section XI)

PART XII - REMARKS 49 REMARKS (Use this space for any additional information or statements that you would like to make concerning your application)


PART XII - REMARKS (Continued)

Page 9

49 REMARKS (Continued) (Use this space for any additional information or statements that you would like to make concerning your application)

PENALTY The law provides severe penalties which include fine or imprisonment or both for the willful submission of any statement or evidence of a material fact knowing it to be false or for the fraudulent acceptance of any payment which you are not entitled to


STEP 8 Facility Certification (Please submit a current statement showing the fees the claimant pays to your facility and a breakdown of the care received)

I CERTIFY the information stated within this WORKSHEET FOR AN ASSISTED LIVING ADULT DAY CARE OR SIMILAR FACILITY is accurate and

reflects the current environment pertaining to _______________________________________________________________________________________

and hisher care at this facility (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________

WORKSHEET FOR AN ASSISTED LIVING ADULT DAY CARE OR A SIMILAR FACILITYNOTE Only complete this worksheet if you are claiming expenses for an assisted living facility adult day care or similar facility

IMPORTANT VA recognizes the following five activities as Activities of Daily Living (ADLs) for medical expense purposes (1) Eating (2) BathingShowering (3) Dressing (4) Transferring (for example from bed to chair) (5) Using the toilet Custodial Care is regular - bull assistance with two or more ADLs or bull supervision because a person with a mental disorder is unsafe if left alone due to the mental disorder INSTRUCTIONS Use this worksheet if you are claiming a disabled persons care in an assisted living facility adult day care or similar facility as unreimbursed medical expenses Follow the steps below to determine whether VA may deduct all or some of your out-of-pocket payments to the facility

STEP 1 Are the expenses you wish to claim due to the disabled persons treatment in a hospital inpatient treatment center nursing home or VA approved medical foster home

YES NO

(If NO payments to the facility do not qualify as medical expenses You are finished completing this worksheet)

(If YES all payments to the facility qualify as medical expenses in Items 45A thru 45F You are finished completing this worksheet) STEP 2 Do all of the following apply to the facility bull The facility is licensed (if the State or Country requires it) bull The facilitys staff (or the facilitys contracted staff) provides the disabled person with health care or custodial care or both bull If the facility is residential it is staffed 24 hours per day with caregivers

YES NO

STEP 3 Are you (the claimant) the disabled person a surviving spouse or a Parents DIC claimant

YES NO (If NO skip to Step 6)

STEP 4 Did you claim special monthly pension in Item 31

YES NO (If NO payments to this facility for meals and lodging do not qualify as medical expenses Only claim amount you pay the facility for health care services or assistance with ADLs provided by a health care provider in Items 45A thru 45F Skip to Step 8)

STEP 5 If you answered YES in Step 2 you stated that the facility provides you with health care andor custodial care Is this the primary reason you live in the facility (or attend day care in the facility)

YES NO

(If YES all payments to this facility may qualify as medical expenses in Items 45A thru 45F if VA rates you as eligible for special monthly pension or special monthly DIC Please report separately in Items 45A - 45F applicable amounts you pay the facility for (1) lodging and meals (2) health care services or assistance with ADLs provided by a health care provider and (3) custodial care Skip to Step 8)

STEP 6 Does the disabled person require the health care services or custodial care that the facility provides to him or her because of the disabled persons mental or physical disability

YES NO

(If YES you must submit a statement from a physician or physician assistant that (1) the disabled person requires the health care services or custodial care that the facility provides to him or her because of mental or physical disability and (2) describes the mental or physical disabilty)

(If NO claim only amounts you pay the facility for health care services or assistance with ADLs provided by a health care provider in Items 45A thru 45F Skip to Step 8)

STEP 7 If you answered YES in Step 2 you stated that the facility provides the disabled person with health care andor custodial care Is this the primary reason the disabled person lives in the facility (or attends day care in the facility)

YES NO (If NO payments to this facility for meals and lodging do not qualify as medical expenses Only claim amounts you pay the facility for health care services or custodial care in Items 45A thru 45F)

(If NO continue to Step 2)

(If NO payments to this facility for meals and lodging do not qualify as medical expenses Please report separately in Items 45A thru 45F applicable amounts you pay the facility for (1) health care services or assistance with ADLs provided by a health care provider and (2) custodial care Skip to Step 8)

(If YES claim all payments to this facility (to include meals and lodging) as medical expenses in Items 45A thru 45F)

(Name of individual staying at your facility)

(Name and address of facility)

(Name Signature Title at Facility) (Date)

0VA FORM 21P-534 OCT 2018

STEP 7 In-Home Attendant Certification (Please submit a breakdown of the time the attendant spends assisting the disabled person with health care services ADLs and IADLs)

STEP 4 Does the disabled person require the health care services or custodial care that the in-home attendant provides to him or her because of the disabled persons mental or physical disability

STEP 2 Did you claim special monthly pension on Item 31

WORKSHEET FOR IN-HOME ATTENDANT EXPENSESNOTE Only complete this worksheet if you are claiming expenses for in-home care

IMPORTANT VA recognizes the following five activities as Activities of Daily Living (ADLs) for medical expense purposes (1) Eating (2) BathingShowering (3) Dressing (4) Transferring (for example from bed to chair) (5) Using the toilet Custodial Care is regular - bull assistance with two or more ADLs or bull supervision because a person with a mental disorder is unsafe if left alone due to the mental disorder IMPORTANT The following activities are examples of Instrumental Activities of Daily Living (IADLs) for VA purposes VA generally does not recognize assistance with these activities as medical expenses (1) Shopping (2) Food Preparation (3) Housekeeping (4) Laundering (5) Handling medications (6) Using the telephone (7) Transportation (except for medical purposes such as transportation to a doctors appointment) INSTRUCTIONS Use this worksheet if you are claiming payments to a disabled persons in-home attendant as an unreimbursed medical expense Follow the steps below to determine whether or not bull the attendant must be a health care provider for VA purposes and bull VA may deduct payment for assistance with IADLs as well as assistance with ADLs and custodial care

STEP 1 Are you (the claimant) the disabled person a surviving spouse or Parents DIC claimant


YES NO (If NO the in-home attendant must be a health care provider and payments for assistance with IADLs do not qualify as medical expenses Payments for health care services or custodial care qualify as medical expenses You may claim these expenses in Items 45A thru 45F Skip to Step 6)

STEP 3 Is the primary responsibility of the in-home attendant to provide you with health care or custodial care

YES NO

(If YES payments to this in-home attendant may qualify as medical expenses if VA rates you as eligible for special monthly pension Please report separately in Items 45A - 45F amounts you pay an in-home attendant for (1) health-care services or assistance with ADLs provided by a health care provider (2) assistance with IADLs and (3) custodial care Skip to Step 6)

(If YES you must submit a statement from a physician or physician assistant that (1) the disabled person requires the health care services or custodial care that the in-home attendant provides the disabled person because of the disabled persons mental or physical disability and (2) describes the mental or physical disability)

(If NO payments to this in-home attendant for assistance with IADLs do not qualify as medical expenses Please report separately in Items 45A thru 45F applicable amounts you pay an in-home attendant for (1) health care services or assistance with ADLs provided by a health care provider and (2) custodial care Skip to Step 6)

(If NO the attendant must be a health care provider Only report payments to the in-home attendant for health care services or assistance with ADLs provided by the health care provider as medical expenses in Items 45A thru 45F Payments for assistance with IADLS do not qualify as medical expenses Skip to Step 6)

STEP 5 Is the primary responsibility of the in-home attendant to provide the disabled person with health care or custodial care

(If YES payments to the in-home attendant qualify as medical expenses (even assistance with IADLs) and can be reported in Items 45A thru 45F) YES NO

YES NO

I CERTIFY the information within this WORKSHEET FOR IN-HOME ATTENDANT EXPENSES is accurate and reflects the current environment

pertaining to _______________________________________________________________________________________ and hisher care

from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________

(Name of Individual Requiring Care)

(Name of Attendant)

(Name Signature Title) (Date)

(If NO report payments to this in-home attendant for health care andor custodial care as medical expenses in Items 45A thru 45F Payment for assistance with IADLs do not qualify as medical expense)

STEP 6 Check all activities below with which the attendant assists the disabled person ADLs

IADLs

EATING BATHINGSHOWERING DRESSING

HOUSEKEEPING

TRANSFERRING USING THE TOILET

SHOPPING FOOD PREPARATION LAUNDERING MANAGING FINANCES

HANDLING MEDICATIONS USING THE TELEPHONE TRANSPORTANTION (FOR NON-MEDICAL PURPOSES)


Page 12

4 DATE OF BIRTH

Form Approved OMB Approved No 0960-0062

(DO NOT WRITE IN THIS SPACE) VA DATE STAMP

1 FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN (Type or print)

NOTE If the veterans Social Security No is unknown complete Items 4 5 6 and 7 about veteran

3 SOCIAL SECURITY NO OF VETERAN

2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER 7 MAIDEN NAME OF MOTHER 8 DID THE VETERAN WORK IN THE RAILROAD INDUSTRY AT ANY TIME AFTER 1936

NOTE The following information should be furnished for each period of the veterans active service (regular or reserves) after September 7 1939 in the military service of the United States or service as a commissioned officer in the Public Health Service or the National Oceanic and Atmospheric Administration or during WWII Philippine or Filipino or Allied country military service If additional space is needed attach a separate sheet

9A DATE ENTERED ACTIVE SERVICE 9B SERVICE NO 9C DATE SEPARATED FROM ACTIVE SERVICE

9D GRADE RANK OR RATING ORGANIZATION AND BRANCH OF SERVICE

10 RELATIONSHIP OF APPLICANT TO VETERAN 11 DATE OF BIRTH OF APPLICANT 12 VA FILE NO

CHILDREN Show names of surviving children (including natural children adopted children and stepchildren) or dependent grandchildren (including step grandchildren) who at any time since the veteran died were unmarried and (a) under age 18 (b) age 18 to 19 and attending secondary school (c) disabled or handicapped (18 or over and disability began before age 22)

13A

13C

13B

13D

I know that anyone who makes or causes to be made a false statement or representation of a material fact in an application or for use in determining a right to payment under the Social Security Act commits a crime punishable under Federal law by fine imprisonment or both I affirm that all information I have given in this document is true

14 DATE (Month day year) 15 SIGNATURE OF APPLICANT (First name middle initial last name) (Sign in ink)

16 MAILING ADDRESS OF APPLICANT (No and street or rural route city or PO State and ZIP Code) 17 TELEPHONE NO (Include Area Code)

WITNESSES REQUIRED ONLY IF SIGNATURE OF APPLICANT IS MADE BY X MARK ABOVE

19A SIGNATURE OF WITNESS 19B ADDRESS OF WITNESS (No and street city State and ZIP Code)

18A SIGNATURE OF WITNESS

ITEMS BELOW TO BE COMPLETED BY THE DEPARTMENT OF VETERANS AFFAIRS Use reverse for Remarks

18B ADDRESS OF WITNESS (No and street city State and ZIP Code)

22 DATE 23 NAME AND ADDRESS OF TRANSMITTING VA OFFICE

20 PROOFS RECEIVED 21 PROOFS REQUESTED FROM CLAIMANT OR OTHER (Specify)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

SOCIAL SECURITY ADMINISTRATIONAPPLICATION FOR SURVIVORS BENEFITS

(PAYABLE UNDER TITLE II OF THE SOCIAL SECURITY ACT)IMPORTANT - Read instructions before completing form Detach and retain ONLY the instruction sheet

Form SSA-24 (2-2002) Destroy All Prior Editions

NO YES

CHILD SURVIVING SPOUSE PARENT

Page 13

IMPORTANT PLEASE READ THE FOLLOWING BEFORE YOU COMPLETE THE SSA-24 INSTRUCTIONS FOR COMPLETING FORM SSA-24 APPLICATION FOR SURVIVORS BENEFITS

(Payable Under Title II of the Social Security Act)

enable a third party or an agency to assist Social Security in establishing an individuals right to benefits or coverage

comply with Federal laws which require or authorize the release of information from social security records and

facilitate statistical research and audit activities necessary to assure the integrity and improvement of the social security programs

If you should have any question about entitlement to social security benefits or the information you have provided on this form please contact your local social security office

Complete each item of the attached application Form SSA-24 (except Items 20 through 23) When signed and dated the form SHOULD BE LEFT ATTACHED to your completed

VA Form 21P-534 Application for Dependency and Indemnity Compensation Death Pension a and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable) or

VA Form 21P-535 Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation When Applicable)

This application form SSA-24 is an Application for Survivors Benefits Payable under Title II of the Social Security Act as amended Under authority of section 202(o) of the Social Security Act the application requests information in order to determine eligibility to social security benefits

You do not have to complete this application there are no penalties under the law if you do not complete part or all of the SSA-24 However it is usually to your advantage to provide the information because not providing it could prevent an accurate and timely decision on your claim or could result in the loss of some benefits or insurance coverage

If you do wish to supply the information requested on the SSA-24 this information will be forwarded to the Social Security Administration and used by them to determine whether social security benefits may be payable to surviving dependent(s) of the veteran Social Security will then contact you regarding any social security benefits payable based on information given on this form

Please understand that Social Security may in certain instances disclose the information on this form to another Federal State or local agency or individual without your written consent This would be done in order to

PAPERWORK REDUCTION ACT This information collection meets the clearance requirements of 44 USC 3507 as amended by section 2 of the Paperwork Reduction Act of 1995 You are not required to answer these questions unless we display a valid Office of Management and Budget control number We estimate that it will take you about 15 minutes to read the instructions gather the necessary facts and answer the questions


If you have any questions about this form how to fill it out or about VA benefits contact your nearest VA regional office

You can locate the address of the nearest regional office in your telephone book blue pages under United States Government Veterans or call 1-800-827-1000 (Hearing Impaired TDD line is 711) You may also contact VA by Internet at httpsiriscusthelpcom




B What is the purpose of VA Form 21P-534

Use VA Form 21P-534 to apply for

VA benefits you may be entitled to receive as a surviving spouse or child

of a deceased veteran and

any money VA owes the veteran but did not pay prior to his or her death (accrued benefits)

NOTE If you apply for any one of these benefits the law requires that we also consider you for the others

C What is the purpose of the attached SSA-24 form

You can apply for Social Security (SS) benefits by using the SSA-24 form attached to this VA Form (see pages 12 and 13) You dont have to apply if you dont want to or have already done so If you do want to apply fill it out and leave it attached We will send it to the Social Security Administration for you They will then contact you

D What are dependency and indemnity compensation (DIC) and Survivors Pension benefits and how does VA decide what I will or will not receive

1 Dependency and indemnity compensation may be payable when

a veterans death occurred while on active service or a veteran dies of a service-connected disability or disabilities that waswere either the principal or contributory cause of death or a veteran died from a non-service connected injury or disease AND was receiving or entitled to receive VA compensation for a service-

connected disability rated totally disabling

For at least 10 years immediately before death or

For at least 5 years after the veterans release from active duty preceding death or

For at least 1 year before death if the veteran was a former prisoner of war who died after September 30 1999

2 Survivors Pension may be payable when

the death of a veteran with wartime service is not due to service and

income and assets are within applicable limits

VA pays pension based on the amount of family income and assets and the number of dependent children This is based on law VA must include as income all sources that Federal law specifies If there is no surviving spouse pension may be payable on behalf of a child or children

You must provide information about the Social Security benefits you and your dependents receive Report the gross amount you and your dependents receive monthly before deductions are taken out If you have a copy of your most recent Social Security award letter please include a copy of the letter with your application

You must tell us if you or your dependents receive or received income from sources other than Social Security Please also report if you or your dependents own your primary residence and the value of your assets and your dependents assets Your assets do include your spouses assets Although your assets do not include your childs assets you must tell us if your child has significant assets

Assets means the fair market value of all property that an individual owns including all real and personal property (excluding the value of the primary residence including the residential lot area not to exceed 2 acres) less the amount of mortgages or other encombrances specific to the mortgaged or encumbered property) Personal property means the value of personal effects that are in excess of being suitable and consistent with a reasonable mode of life

Unless a claim for dependency and indemnity compensation or Survivors Pension is filed within 1 year from the date of the veterans death that benefit is not payable from a date earlier than the date the claim is received in the VA

If it is determined that you are entitled to DIC and death pension we will pay you whichever benefit entitles you to the most money Benefit rates and income limits are frequently changed so it is not possible to keep this information current in these instructions You can find out what the current income limitations and rates of benefits are by contacting your nearest VA regional office

VA FORM

OCT 2018

21P-534

SUPERSEDES VA FORM 21-534 JUN 2018 WHICH WILL NOT BE USED

FOR APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION (DIC) SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (INCLUDING DEATH COMPENSATION IF APPLICABLE)VA FORM 21P-534

PAGE 1








A representative can be a VA accredited Veterans Service Organization or other service organization that the Secretary of Veterans Affairs recognizes or a VA accredited attorney or claims agent Agents and attorneys can charge you for services that you get from them only after the Board of Veterans Appeals (BVA) gives you their final decision about your application That means you can use an attorney during any stage of your application for benefits However the agent or attorney cannot charge you for services unless you are trying to resolve a dispute with VA after BVA has made a decision about your claim

If you want to use a representative to help you with your application contact the nearest VA office Depending on the type of representative you want to designate we will send you one of the following forms

bull VA Form 21-22 Appointment of a Veterans Service Organization as Claimants Representative or

bull VA Form 21-22A Appointment of Individual as Claimants Representative

You may also download these forms at wwwvagovvaforms If you have already designated a representative no further action is required on your part



PAGE 2








CProgram FilesFormFlowformsvba-21-534_instructionsxft

Pamela Ward

13013

FF99 ver 31

Electronic Forms

vba-21-534_instructions

CF3222A7-20FA-11D4-ABC1-00D0B71D6ABB

IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING

21I PLACE ENTERED ACTIVESERVICE - First Period

21A ENTERED ACTIVESERVICE - First Period(Month Day Year)


CELL PHONE


iaimainapps1Pam_WardLogosFormlogojpg

Department of Veterans Affairs


EVENING



(VA DATE STAMP)

21H ENTERED ACTIVESERVICE - Second Period(Month Day Year)

21J SERVICE NUMBER

21L PLACE LEFT ACTIVESERVICE - Second Period

21M BRANCH OF SERVICE


21N GRADE RANK

OR RATING

21E PLACE LEFT ACTIVESERVICE - First Period

21D DATE LEFT ACTIVESERVICE - First Period(Month Day Year)

21K DATE LEFT ACTIVESERVICE - Second Period(Month Day Year)


VA FORM OCT 2018

21P-534

PAGE 3

SUPERSEDES VA FORM 21-534 JUN 2018




(If Yes answer Item 2)

YES

15 WHAT IS YOUR RELATIONSHIP TO THE VETERAN (Check one)

16 WHAT IS YOUR ADDRESS (Number and street or rural route city or PO StateZIP Code and Country)



(NOTE Attach a copy of the death certificate unless the veteran

died in active service of the Army Navy Air Force Marine Corps

or Coast Guard or in a US government institution)

21C SERVICE NUMBER

NO








(If Yes answer Items 4 through 6)

YES

NO



YES

NO

OMB Approved No 2900-0004

Respondent Burden 1 hour 15 minutes

Expiration Date 10312021


(If Yes answer Item 10B)

YES

NO



YES

NO

SURVIVING SPOUSE

CHILD

19 WHAT IS YOUR SOCIAL SECURITY NUMBER

20 WHAT IS THE YOUR DATE OF BIRTH (Month Day Year)

IMPORTANT Enter complete information for all periods of service If more space is needed use Item 49 Remarks If the veteran never filed a claim with

VA attach the original DD214 or a certified copy for each period of service listed We will return original documents to you

21B PLACE ENTERED ACTIVESERVICE - First Period

PART IV - MARITAL INFORMATION

(Attach a copy of your marriage certificate showing your marriage to the veteran)

PART V - DEPENDENT CHILDREN (Complete ONLY if claiming benefits for a child(ren) of the veteran)

(Skip to Section VI if you are NOT claiming benefits for a child(ren) of the veteran)

26 DID YOU LIVE CONTINUOUSLY WITH THE VETERAN FROM THE DATE

OF MARRIAGE TO THE DATE OF HISHER DEATH

23B HAVE YOU REMARRIED SINCE THE DEATH OF THE VETERAN

23A HOW MANY TIMES HAVE YOU BEEN MARRIED (Include your marriage to the

veteran)

23C DATE (month day year) and PLACE

OF MARRIAGE (citystate or country)


(death divorce)

22B DATE (month day year) and PLACE

OF MARRIAGE (city state or country)

22C TO WHOM MARRIED

(first middle last name)

22D TYPE OF MARRIAGE

(ceremonial common-law proxy tribal or other)




23F HOW MARRIAGE

TERMINATED

(death divorce marriage has not

been terminated)



23G DATE (month day year) and PLACE MARRIAGE TERMINATED



24 WAS A CHILD BORN TO YOU AND THE VETERAN DURING YOUR MARRIAGE

OR PRIOR TO YOUR MARRIAGE

Page 4





27 WHAT WAS THE CAUSE OF SEPARATION GIVE THE REASON DATE(S) AND

DURATION OF THE SEPARATION (IF THE SEPARATION WAS BY COURT ORDER

ATTACH A COPY OF THE ORDER)


23D TO WHOM MARRIED


23E TYPE OF MARRIAGE



Provide information in Items 23c through 23G for all of your marriages)

(Answer Item 24 only if you were married to the veteran

less than one year)

TELL US ABOUT THE UNMARRIED CHILDREN OF THE VETERAN

NOTE You should provide a copy of the public record of birth or a copy of the court record of adoption for each child listed in Item 29A unless the veteran

was receiving additional VA benefits for the child

If you need additional space please attach a separate VA Form 21-686c Declaration of Status of Dependents providing the requested information

about each child

IMPORTANT Skip to Part VI if you are not claiming benefits for any children that meet the following criteria

VA recognizes the veterans biological children adopted children and stepchildren as dependents These children must be unmarried and

∙

under age 18 or

at least 18 but under 23 and pursuing an approved course of education or

of any age if they became permanently unable to support themselves before reaching at 18

∙

∙

Seriously disabled (Item 29H) means that the child became permanently unable to support himselfherself before reaching age 18 Furnish a statement from an attending physician or other medical evidence which shows the nature and extent of the physical or mental impairment

Note to surviving spouse If entitlement to DIC is established a seriously disabled child over age 18 is entitled to receive DIC benefits in his or her own right A

veterans child who is seriously disabled and over age 18 must submit a separate VA Form 21-534 to apply for benefits

NOTE You must furnish complete information about all marriages of the surviving spouse and the veteran If you need additional space please

attach a separate VA Form 21-686c Declaration of Status of Dependents providing the requested information

If you are claiming benefits as the surviving spouse of the veteran you should complete Items 22A through 28 If you are not the surviving spouse skip to Section V


NOTE If you are claiming aid and attendance allowance andor housebound benefits because you need the regular assistance of another person are

having severe visual problems or are housebound and not in a nursing home submit a statement from your doctor showing the extent of your disabilities

If you are in a nursing home attach a statement signed by an official of the nursing home showing the date you were admitted the level of care you receive

the amount you pay out-of-pocket for your care and whether Medicaid covers all or part of your nursing home costs



Page 5

31 ARE YOU CLAIMING SPECIAL MONTHLY PENSION BECAUSE YOU NEED THE REGULAR ASSISTANCE OF ANOTHER PERSON HAVE SEVERE VISUAL

PROBLEMS OR ARE CONFINED TO YOUR IMMEDIATE PREMISES

32A ARE YOU NOW IN A NURSING HOME

32B PROVIDE THE NAME AND COMPLETE MAILING ADDRESS OF THE FACILITY

32C DOES MEDICAID COVER ALL OR PART OF YOUR NURSING HOME COSTS

32D HAVE YOU APPLIED FOR MEDICAID

(If No answer Item 32D)


29A NAME OF CHILD

(First middle initial last name)

(Check all that apply)

29G

18-23 YEARS

OLD (in school)

30B CHILDS COMPLETE ADDRESS

(Number and street or rural route city or PO city State ZIP Code and country)


29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD


29B DATE (month day year) and PLACE OF BIRTH


30D MONTHLY AMOUNT YOU

CONTRIBUTE TO THE CHILDS SUPPORT


$

$


(Skip to Section VI if you are NOT claiming benefits for a child(ren) of the veteran) (Continued)




33A HAVE YOU CLAIMED OR ARE YOU RECEIVING BENEFITS FROM THE SOCIAL SECURITY ADMINISTRATION ON YOUR OWN BEHALF OR ON BEHALF OF

A CHILD OR CHILDREN IN YOUR CUSTODY


34 HAS A SURVIVING SPOUSE OR CHILD FILED A CLAIM FOR COMPENSATION FROM THE OFFICE OF WORKERS COMPENSATION PROGRAMS BASED

ON THE DEATH OF THE VETERAN


36 HAVE YOU CLAIMED OR ARE YOU RECEIVING SURVIVOR BENEFIT PLAN (SBP) ANNUITY FROM A SERVICE DEPARTMENT BASED ON THE DEATH OF

THE VETERAN

Page 6

VA Form 21P-534 OCT 2018



SOCIAL SECURITY RECIPIENT

GROSS MONTHLY AMOUNT


$

$

$

$

$




IMPORTANT VA matches income information reported with Federal tax information Report ALL income you and your dependents

receive on the appropriate sections of this form and VA Form 21P-0969 Income and Asset Statement if appropriate

39A WHAT IS THE SIZE OF THE LOT ON WHICH YOUR

PRIMARY RESIDENCE SITS (Square Feet)



40A OTHER THAN SOCIAL SECURITY DO YOU OR YOUR DEPENDENTS

RECEIVE ANY INCOME

40B OTHER THAN SOCIAL SECURITY DID YOU OR YOUR DEPENDENTS RECEIVE

ANY INCOME LAST YEAR

40C DO YOU OR YOUR DEPENDENTS HAVE MORE THAN $10000 IN ASSETS (NOTE Assets are all the money and property you or your dependents own Assets

do not include your primary residence or personal effects such as appliances and vehicles you or your dependents need for transportation)

40D IN THE THREE CALENDAR YEARS BEFORE THIS YEAR DID YOU OR YOUR DEPENDENTS TRANSFER ANY ASSETS (Examples of asset transfers include giving

them away selling them purchasing an annuity or using them to establish a trust)


(If Yes you must also complete VA Form 21P-0969 Income and Asset Statement)

PART IX - DIRECT DEPOSIT INFORMATION

The Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT) also called direct deposit Please attach a voided personal check or deposit slip or provide the information requested below in Items 41 42 and 43 to enroll in direct deposit If you do not have a bank account you must receive your payment through Direct Express Debit MasterCard To request a Direct Express Debit MasterCard you must apply at wwwusdirectexpresscom or by telephone at 1-800-333-1795 If you elect not to enroll you must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950 They will encourage your participation in EFT and address any questions or concerns you may have




Account No__________________

Account No__________________

$

$

$

$




Family medical expenses and certain other expenses actually paid by you may be deductible from your income Show the amount of any unreimbursed medical expenses including the Medicare deduction you paid over the last year (or expect to pay and continue indefinitely) for yourself or relatives who are members of your household

Also show unreimbursed last illness and burial expenses and educational or vocational rehabilitation expenses you paid Last illness and burial expenses are unreimbursed amounts paid by you for the veterans or hisher childs last illness and burial and the veterans just debts Educational or vocational rehabilitation expenses are amounts paid for courses of education including tuition fees and materials Do not include any expenses for which you were reimbursed If you receive reimbursement after you have filed this claim promptly advise the VA office handling your claim If more space is needed attach a separate VA Form 21P-8416 Medical Expense Report

IMPORTANT If you are claiming expenses for in-home care or assisted living adult day care or similar facility you must complete the applicable worksheet(s) on pages 10 and 11


Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO

(Name of provider Insurance company nursing home etc)

45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$






46A SIGNATURE (Provide your signature in the box DO NOT PRINT) (If you sign with an X then you must have 2 people you

know witness as you sign They must then sign the form and print their names and addresses)







PART XII - REMARKS

49 REMARKS (Use this space for any additional information or statements that you would like to make concerning your application)


Page 8


Page 9


PENALTY The law provides severe penalties which include fine or imprisonment or both for the willful submission of any statement or evidence of a

material fact knowing it to be false or for the fraudulent acceptance of any payment which you are not entitled to


STEP 8 Facility Certification (Please submit a current statement showing the fees the claimant pays to your facility and a breakdown of the care

received)

I CERTIFY the information stated within this WORKSHEET FOR AN ASSISTED LIVING ADULT DAY CARE OR SIMILAR FACILITY is accurate and reflects the current environment pertaining to _______________________________________________________________________________________ and hisher care at this facility (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________

WORKSHEET FOR AN ASSISTED LIVING ADULT DAY CARE OR A SIMILAR FACILITY

NOTE Only complete this worksheet if you are claiming expenses for an assisted living facility adult day care or similar facility

IMPORTANT VA recognizes the following five activities as Activities of Daily Living (ADLs) for medical expense purposes

(1) Eating

(2) BathingShowering

(3) Dressing

(4) Transferring (for example from bed to chair)

(5) Using the toilet

Custodial Care is regular -

bull assistance with two or more ADLs or

bull supervision because a person with a mental disorder is unsafe if left alone due to the mental disorder

INSTRUCTIONS Use this worksheet if you are claiming a disabled persons care in an assisted living facility adult day care or similar facility as unreimbursed medical expenses Follow the steps below to determine whether VA may deduct all or some of your out-of-pocket payments to the facility

STEP 1 Are the expenses you wish to claim due to the disabled persons treatment in a hospital inpatient treatment center

nursing home or VA approved medical foster home


(If YES all payments to the facility qualify as medical expenses in Items 45A thru 45F You are finished completing this worksheet)

STEP 2 Do all of the following apply to the facility

bull The facility is licensed (if the State or Country requires it)

bull The facilitys staff (or the facilitys contracted staff) provides the disabled person with

health care or custodial care or both

bull If the facility is residential it is staffed 24 hours per day with caregivers


(If NO skip to Step 6)


(If NO payments to this facility for meals and lodging do not qualify as medical expenses Only claim amount you pay the facility for

health care services or assistance with ADLs provided by a health care provider in Items 45A thru 45F Skip to Step 8)

STEP 5 If you answered YES in Step 2 you stated that the facility provides you with health care andor custodial care

Is this the primary reason you live in the facility (or attend day care in the facility)


STEP 6 Does the disabled person require the health care services or custodial care that the facility provides to him or her because of the disabled

persons mental or physical disability

(If YES you must submit a statement from a physician or physician assistant that (1) the disabled person requires the health care services

or custodial care that the facility provides to him or her because of mental or physical disability and (2) describes the mental or physical disabilty)

(If NO claim only amounts you pay the facility for health care services or assistance with ADLs provided by a health care provider in

Items 45A thru 45F Skip to Step 8)

STEP 7 If you answered YES in Step 2 you stated that the facility provides the disabled person with health care andor custodial care

Is this the primary reason the disabled person lives in the facility (or attends day care in the facility)

(If NO payments to this facility for meals and lodging do not qualify as medical expenses Only claim amounts you pay the facility for health care services or custodial care in Items 45A thru 45F)


(If NO payments to this facility for meals and lodging do not qualify as medical expenses Please report separately in Items 45A thru 45F

applicable amounts you pay the facility for (1) health care services or assistance with ADLs provided by a health care provider

and (2) custodial care Skip to Step 8)




(Name Signature Title at Facility)

(Date)

Page 10


STEP 7 In-Home Attendant Certification (Please submit a breakdown of the time the attendant spends assisting the disabled person with health care

services ADLs and IADLs)

STEP 4 Does the disabled person require the health care services or custodial care that the in-home attendant provides to him or her because of the

disabled persons mental or physical disability


WORKSHEET FOR IN-HOME ATTENDANT EXPENSES

NOTE Only complete this worksheet if you are claiming expenses for in-home care


(1) Eating


(3) Dressing






IMPORTANT The following activities are examples of Instrumental Activities of Daily Living (IADLs) for VA purposes VA generally does not recognize assistance

with these activities as medical expenses (1) Shopping (2) Food Preparation (3) Housekeeping (4) Laundering (5) Handling medications (6) Using the telephone

(7) Transportation (except for medical purposes such as transportation to a doctors appointment)

INSTRUCTIONS Use this worksheet if you are claiming payments to a disabled persons in-home attendant as an unreimbursed medical expense

Follow the steps below to determine whether or not

bull the attendant must be a health care provider for VA purposes and

bull VA may deduct payment for assistance with IADLs as well as assistance with ADLs and custodial care



(If NO the in-home attendant must be a health care provider and payments for assistance with IADLs do not qualify as medical expenses Payments for health care services or custodial care qualify as medical expenses You may claim these expenses in Items

45A thru 45F Skip to Step 6)



(If YES you must submit a statement from a physician or physician assistant that (1) the disabled person requires the health care

services or custodial care that the in-home attendant provides the disabled person because of the disabled persons mental or physical disability and (2) describes the mental or physical disability)

(If NO payments to this in-home attendant for assistance with IADLs do not qualify as medical expenses Please report separately in

Items 45A thru 45F applicable amounts you pay an in-home attendant for (1) health care services or assistance with

ADLs provided by a health care provider and (2) custodial care Skip to Step 6)



(If YES payments to the in-home attendant qualify as medical expenses (even assistance with IADLs) and can be reported in

Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)

(Name Signature Title)

(Date)

(If NO report payments to this in-home attendant for health care andor custodial care as medical expenses in Items 45A thru 45F

Payment for assistance with IADLs do not qualify as medical expense)

STEP 6 Check all activities below with which the attendant assists the disabled person

ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH

Form ApprovedOMB Approved No 0960-0062

(DO NOT WRITE IN THIS SPACE)VA DATE STAMP




2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER

7 MAIDEN NAME OF MOTHER

8 DID THE VETERAN WORK IN THE RAILROAD INDUSTRY AT ANY TIME AFTER 1936


9A DATE ENTERED ACTIVE SERVICE

9B SERVICE NO

9C DATE SEPARATED FROM ACTIVESERVICE


10 RELATIONSHIP OF APPLICANT TO VETERAN

11 DATE OF BIRTH OF APPLICANT

12 VA FILE NO


13A

13C

13B

13D


14 DATE (Month day year)

15 SIGNATURE OF APPLICANT (First name middle initial last name) (Sign in ink)

16 MAILING ADDRESS OF APPLICANT (No and street or rural route city or PO State and ZIP Code)

17 TELEPHONE NO (Include Area Code)







22 DATE

23 NAME AND ADDRESS OF TRANSMITTING VA OFFICE

20 PROOFS RECEIVED

21 PROOFS REQUESTED FROM CLAIMANT OR OTHER (Specify)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

SOCIAL SECURITY ADMINISTRATION

APPLICATION FOR SURVIVORS BENEFITS

(PAYABLE UNDER TITLE II OF THE SOCIAL SECURITY ACT)

IMPORTANT - Read instructions before completing form Detach and retain ONLY the instruction sheet


Page 13

IMPORTANT PLEASE READ THE FOLLOWING BEFORE YOU COMPLETE THE SSA-24

INSTRUCTIONS FOR COMPLETING FORM SSA-24 APPLICATION FOR SURVIVORS BENEFITS


enable a third party or an agency to assist Social Security in establishing an individuals

right to benefits or coverage


facilitate statistical research and audit activities necessary to assure the integrity and

improvement of the social security programs


Complete each item of the attached application Form SSA-24 (except Items 20 through 23) When

signed and dated the form SHOULD BE LEFT ATTACHED to your completed

VA Form 21P-534 Application for Dependency and Indemnity Compensation Death Pension a

and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable) or

VA Form 21P-535 Application for Dependency and Indemnity Compensation by Parent(s)(Including Accrued Benefits and Death Compensation When Applicable)







Department of Veterans Affairs 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

2B VA FILE NUMBER

6B WHERE DID YOU GET MARRIED (City State or Country)

15B PLACE OF MARRIAGE (City State or Country)


17F REASON MARRIAGE ENDED (Death Divorce)

17C NAME OF FORMER SPOUSE (First Middle Last)


7 SPOUSES NAME (First middle last)

12 SPOUSES ADDRESS (Number and street or rural route city or PO State13and ZIP Code)

3 ADDRESS OF VETERANCLAIMANT (Number street or rural route City or PO State and ZIP Code)

9 SPOUSES SOCIAL SECURITY NUMBER Enter 9 digit social security number

10 A IS YOUR SPOUSE ALSO A VETERAN YES If Yes complete Item 10B if known 0

10 A IS YOUR SPOUSE ALSO A VETERAN NO 0

6 A WHEN WERE YOU MARRIED Enter 2 digit month 2 digit day and 4 digit year

15 A DATE OF MARRIAGE LINE 1 OF 3 Enter 2 digit month 2 digit day and 4 digit year

2B VA FILE NUMBER




5 WHAT IS YOUR MARITAL STATUS NEVER MARRIED IF NEVER MARRIED OR SAME SEX MARRIAGE SKIP TO PART 3 0



SSN


Enter 2 digit month 2 digit day and 4 digit year



PlaceMarriageTerminated

ExplainOtherTypeofMarriage

HowMarriageTerminated

ProvideExplanation

ProvideCauseofSeparation

Name_Of_Person_Married_To_Veteran

Number_Of_Times_You_Have_Been_Married

TypeofMarriage

Numberoftimes_Veteran_Was_Married

ToWhomMarried


PlaceofMarriage


Name_Of_Person_That_You_Were_Married_To

Name_And_Complete_Mailing_Address_Of_Nursing_Home

JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1

MonthlyAmountofSupport

MonthyAmountofSupport

NameofPersonChildLivesWith


PlaceofBirth

Childs_SSN

SocialSecurityRecipient3





Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet

RoutingorTransitNumber

NameofFinancialInstitution

CheckingAccountNumber

SavingsAccountNumber


Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid

Printed_Name_And_Address_Of_Witness


Name_And_Address_Of_Witness

Remarks

Remarks_Continued

44 A SIGNATURE OF WITNESS (Do not print) This is a protected field



42C DATE SIGNED Enter 2 digit month 2 digit day and 4 digit year

1 Enter FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN (Type or print)

3 SOCIAL SECURITY NUMBER OF VETERAN Enter 9 digit social security number

5 Enter PLACE OF BIRTH

6 Enter NAME OF FATHER

7 Enter MAIDEN NAME OF MOTHER

8 No 0

8 Yes 0

9B Enter SERVICE NUMBER

9D Enter GRADE RANK OR RATING ORGANIZATION AND BRANCH OF SERVICE





12 Enter V A FILE NUMBER

13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2

15 Enter SIGNATURE OF APPLICANT (First name middle initial last name) (Sign in ink) This is a protected field

16 Enter MAILING ADDRESS OF APPLICANT (Number and street or rural route city or P O State and ZIP Code)

17 TELEPHONE NUMBER (Include Area Code) Enter 10-digit telephone number including area code

18 A Signature of Witness This is a protected field


19B Enter ADDRESS OF WITNESS (Number and street city State and ZIP Code)


death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)

23 NAME AND ADDRESS OF TRANSMITTING V A OFFICE

10 CHILD 0

10 SURVIVING SPOUSE 0

10 PARENT 0

Specify Other

Specify Other

9 A DATE ENTERED ACTIVE SERVICE Enter 2 digit month 2 digit day and 4 digit year Line 1 of 3



9C DATE SEPARATED FROM ACTIVE SERVICE Enter 2 digit month 2 digit day and 4 digit year



11 DATE OF BIRTH OF APPLICANT Enter 2 digit month 2 digit day and 4 digit year

14 Date Enter 2 digit month 2 digit day and 4 digit year


2 DATE OF DEATH Enter 2 digit month 2 digit day and 4 digit year

4 DATE OF BIRTH Enter 2 digit month 2 digit day and 4 digit year







A representative can be a VA accredited Veterans Service Organization or other service organization that the Secretary of Veterans Affairs recognizes or a VA accredited attorney or claims agent Agents and attorneys can charge you for services that you get from them only after the Board of Veterans Appeals (BVA) gives you their final decision about your application That means you can use an attorney during any stage of your application for benefits However the agent or attorney cannot charge you for services unless you are trying to resolve a dispute with VA after BVA has made a decision about your claim If you want to use a representative to help you with your application contact the nearest VA office Depending on the type of representative you want to designate we will send you one of the following forms bull VA Form 21-22 Appointment of a Veterans Service Organization as Claimants Representative or bull VA Form 21-22A Appointment of Individual as Claimants Representative You may also download these forms at wwwvagovvaforms If you have already designated a representative no further action is required on your part



PAGE 2VA FORM 21P-534 OCT 2018








DAYTIME





(Month Day Year)


CELL PHONE



EVENING



(VA DATE STAMP)


(Month Day Year)

21J SERVICE NUMBER






(Month Day Year)


(Month Day Year)











21C SERVICE NUMBER

NO










YES NO






YES NO

SURVIVING SPOUSE

CHILD








YES NO YES NO



(death divorce)











YES NO






Page 4











NO

YES NO












Page 5




YES NO

YES NO









29D BIOLOGICAL

$


29F STEPCHILD

29I CHILD

MARRIED


MARRIED

29E ADOPTED





SUPPORT


$

$




YES




YES NO


YES NO


YES NO


NO






$

$

$

$

$

YES NO





YES NO





YES NO


YES NO


YES NO


YES NO









$

$

$

$

YES NO







nursing home etc)



EXPENSES WERE PAID

45F AMOUNT YOU PAY


$

$

$

$

$

$

$

$

$

$


YES NO




$

$
















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO











Page 10VA FORM 21P-534 OCT 2018










YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other













DAYTIME





(Month Day Year)


CELL PHONE



EVENING



(VA DATE STAMP)


(Month Day Year)

21J SERVICE NUMBER






(Month Day Year)


(Month Day Year)











21C SERVICE NUMBER

NO










YES NO






YES NO

SURVIVING SPOUSE

CHILD








YES NO YES NO



(death divorce)











YES NO






Page 4











NO

YES NO












Page 5




YES NO

YES NO









29D BIOLOGICAL

$


29F STEPCHILD

29I CHILD

MARRIED


MARRIED

29E ADOPTED





SUPPORT


$

$




YES




YES NO


YES NO


YES NO


NO






$

$

$

$

$

YES NO





YES NO





YES NO


YES NO


YES NO


YES NO









$

$

$

$

YES NO







nursing home etc)



EXPENSES WERE PAID

45F AMOUNT YOU PAY


$

$

$

$

$

$

$

$

$

$


YES NO




$

$
















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other
















YES NO YES NO



(death divorce)











YES NO
















NO

YES NO












Page 5




YES NO

YES NO









29D BIOLOGICAL

$


29F STEPCHILD

29I CHILD

MARRIED


MARRIED

29E ADOPTED





SUPPORT


$

$




YES




YES NO


YES NO


YES NO


NO






$

$

$

$

$

YES NO





YES NO





YES NO


YES NO


YES NO


YES NO









$

$

$

$

YES NO







nursing home etc)



EXPENSES WERE PAID

45F AMOUNT YOU PAY


$

$

$

$

$

$

$

$

$

$


YES NO




$

$
















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other



















YES NO

YES NO









29D BIOLOGICAL

$


29F STEPCHILD

29I CHILD

MARRIED


MARRIED

29E ADOPTED





SUPPORT


$

$




YES




YES NO


YES NO


YES NO


NO






$

$

$

$

$

YES NO





YES NO





YES NO


YES NO


YES NO


YES NO









$

$

$

$

YES NO







nursing home etc)



EXPENSES WERE PAID

45F AMOUNT YOU PAY


$

$

$

$

$

$

$

$

$

$


YES NO




$

$
















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other

















$

$

$

$

$

YES NO





YES NO





YES NO


YES NO


YES NO


YES NO









$

$

$

$

YES NO







nursing home etc)



EXPENSES WERE PAID

45F AMOUNT YOU PAY


$

$

$

$

$

$

$

$

$

$


YES NO




$

$
















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other
















nursing home etc)



EXPENSES WERE PAID

45F AMOUNT YOU PAY


$

$

$

$

$

$

$

$

$

$


YES NO




$

$
















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other















Page 9








__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other




















__________________________________________________________________ ___________________




YES NO



YES NO






YES NO



YES NO





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other





















YES NO







YES NO



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)




IADLs


HOUSEKEEPING





Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other












4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH







13A

13C

13B

13D











OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)




NO YES


Page 13













































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other
























































VA FORM

OCT 2018

21P-534



PAGE 1















PAGE 2









Pamela Ward

13013

FF99 ver 31

Electronic Forms



IAI

VBA-21-534

Nancy Kessinger

VBA

Doris Dales

VA Form 21P-534

10

13010


DAYTIME


21G GRADE RANK

OR RATING




CELL PHONE





EVENING



(VA DATE STAMP)


21J SERVICE NUMBER




21N GRADE RANK

OR RATING





VA FORM OCT 2018

21P-534

PAGE 3






YES








21C SERVICE NUMBER

NO









YES

NO



YES

NO






YES

NO



YES

NO

SURVIVING SPOUSE

CHILD














veteran)




(death divorce)



22C TO WHOM MARRIED







23F HOW MARRIAGE

TERMINATED


been terminated)








Page 4









23D TO WHOM MARRIED







less than one year)





about each child



∙

under age 18 or



∙

∙














Page 5









29A NAME OF CHILD



29G

18-23 YEARS

OLD (in school)




29D BIOLOGICAL

$

29H SERIOUSLY

DISABLED

29F

STEPCHILD

29I

CHILD

MARRIED

29J CHILD

PREVIOUSLY MARRIED

29E ADOPTED

30A NAME OF CHILD







$

$













THE VETERAN

Page 6







$

$

$

$

$











RECEIVE ANY INCOME














Account No__________________

Account No__________________

$

$

$

$








Page 7

45C PURPOSE

(Medicare premiums

nursing home etc)

45B PAID TO


45A WHOSE MEDICAL

BURIAL OR OTHER

EXPENSES WERE PAID

45F AMOUNT YOU PAY

45D DATE PAID

(mmddyyyy)

$

$

$

$

$

$

$

$

$

$





$

$














PART XII - REMARKS



Page 8


Page 9






received)


__________________________________________________________________ ___________________




(1) Eating


(3) Dressing









































(Date)

Page 10










(1) Eating


(3) Dressing



























Items 45A thru 45F)



from (_________________________________________________________________________________________________)

__________________________________________________________________ ___________________


(Name of Attendant)


(Date)




ADLs

IADLs

Page 11


Page 12

4 DATE OF BIRTH






2 DATE OF DEATH

5 PLACE OF BIRTH

6 NAME OF FATHER





9B SERVICE NO





12 VA FILE NO


13A

13C

13B

13D












22 DATE


20 PROOFS RECEIVED


OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)

(NAME)

(NAME)

OTHER (Specify)

MARRIAGE

AGE

DEATH

(NAME)

(NAME)






Page 13






















2B VA FILE NUMBER















2B VA FILE NUMBER







SSN








ProvideExplanation




TypeofMarriage


ToWhomMarried


PlaceofMarriage




JF18

JF08

JF10

JF06

JF14

JF16

JF12

JF19

JF09

JF11

JF07

JF17

JF15

JF13

JF22

JF23

JF24

JF25

JF20

JF21

ChildsAddress

NameofChild3

NameofChild2

NameofChild1





PlaceofBirth

Childs_SSN






Amount4

Amount3

Amount2

Amount1

Amount5

SquareFeet






Amount9


Amount8


Amount7


Amount6

Amount10

Amount11

Amount12

Relationship

PaidTo

Purpose

Date_Paid




Remarks

Remarks_Continued










8 No 0

8 Yes 0








13 A Enter Child 1

13C Enter Child 3

13D Enter Child 4

13B Enter Child 2








death 0

age 0

OTHER (Specify) 0

marriage 0

marriage 0

OTHER (Specify) 0

age 0

death 0

(Name)

(Name)

(Name)

(Name)

(Name)

(Name)


10 CHILD 0


10 PARENT 0

Specify Other

Specify Other












va form 21p-534 · supersedes va form 21-534, jun 2018, which will not be used. for application for...

Documents