Part II, Chapter 8. Reference Information



Chapter 8. Reference Information

1. VA Forms

|Introduction |This topic contains information VA forms, including |

| | |

| |the web site for government forms, and |

| |the recommended forms for stocking. |

|Change Date |December 17, 2008 |

|a. Web Site for |Most of the forms listed in this topic can be retrieved and printed from the following web site: |

|Government Forms |. |

| | |

| |Those forms that cannot be found on the web site may be procured from normal stocking points. |

|b. Recommended Forms for|The following forms are recommended for stocking: |

|Stocking | |

|Form Number |Form Name |Revision Date |

|Veterans Health Administration |

|10-10D |Application for CHAMPVA Benefits |06/2005 |

|10-10EZ |Application for Health Benefits |07/2008 |

|10-1394 |Application for Adaptive Equipment – Motor Vehicle |02/2007 |

|10-8678 |Application for Annual Clothing Allowance |07/2006 |

Continued on next page

1. VA Forms, Continued

|b. Recommended Forms for Stocking (continued) |

|Veterans Benefits Administration |

|20-572 |Request for Change of Address/ Cancellation of Direct Deposit |03/1996 |

|Compensation and Pension |

|21-22 |Appointment of Veterans Service Organization as Claimant’s |11/2005 |

| |Representative | |

|21-22a |Appointment of Individual as Claimant’s Representative |05/2007 |

|21-526 |Veteran’s Application for Compensation or Pension |01/2004 |

|21-527 |Income Net Worth and Employment Statement |06/2004 |

|21-530 |Application for Burial Benefits |06/2002 |

|21-534 |Application for Dependency and Indemnity Compensation Death Pension and |06/2005 |

| |Accrued Benefits by Surviving Spouse | |

|21-535 |Application for Dependency and Indemnity Compensation by Parent(s) |04/2005 |

| |(Including Accrued Benefits & Death Compensation) | |

|21-601 |Application for Reimbursement From Accrued Amounts Due a Deceased |05/2005 |

| |Beneficiary | |

|21-674 |Request for Approval of School Attendance |07/2005 |

|21-686c |Declaration of Status of Dependents |11/2004 |

|21-0516 |Improved Pension Eligibility Verification Report Veterans with Spouse |06/2004 |

|21-0516-1 |Improved Pension Eligibility Verification Report Veterans with No |06/2004 |

| |Children | |

|21-0517 |Improved Pension Eligibility Verification Report Veterans with Children |06/2004 |

|21-0518 |Improved Pension Eligibility Verification Report Surviving Spouse with |06/2004 |

| |No Children | |

|21-0519 |Improved Pension Eligibility Verification Report Surviving Spouse with |06/2004 |

| |Children | |

|21-2008 |Application for U.S. Flag for Burial Purposes |09/2005 |

|21-4138 |Statement in Support of Claim |08/2004 |

Continued on next page

1. VA Forms, Continued

|b. Recommended Forms for Stocking (continued) |

|21-4142 |Authorization for Release of Information to the Department of Veterans |05/2004 |

| |Affairs | |

|21-4502 |Application for Automobile or Other Conveyance and Adaptive Equipment |03/2005 |

|21-8416 |Request for Information Concerning Medical/Legal or Other Expenses |11/2004 |

|21-8940 |Veteran’s Application for Increased Compensation Based Upon Unemployment|10/2004 |

|Education |

|22-1990 |Application for Education Benefits |02/2008 |

|22-1995 |Request for Change of Program or Place of Training |12/2005 |

|22-1999 |Enrollment Certification |06/2004 |

|22-5281 |Application for Refund of Education Contributions |07/2007 |

|22-5490 |Application for Survivors and Dependents Educational Assistance |11/2005 |

|Loan Guaranty |

|26-1817 |Request for Determination of Loan Guaranty Eligibility – Unmarried |11/2007 |

| |Surviving Spouses | |

|26-1880 |Request for a Certificate of Eligibility for VA Home Loan Benefits |04/2008 |

|26-4555 |Veterans Application for Acquiring Specially Adapted Housing or Special |10/2005 |

| |Home Adaptation Grant | |

Continued on next page

1. VA Forms, Continued

|b. Recommended Forms for Stocking (continued) |

|Vocational Rehabilitation & Employment |

|28-1900 |Disabled Veterans Application for Vocational Rehabilitation |02/2008 |

|Insurance |

|29-336 |Designation of Beneficiary Government Life Insurance |12/2005 |

|29-357 |Claim for Disability Insurance Benefits |04/2005 |

|29-1546 |Application for Cash Surrender Value or Policy Loan |06/2007 |

|29-4125 |Claim for One Sum Payment |03/2008 |

|29-4364 |Application for Service Disabled Veterans Life Insurance |12/2003 |

|SGLV 8714 |Application for Veterans’ Group Life Insurance |09/2005 |

|SGLV 8721 |Beneficiary Designation Form |08/1996 |

|SGLV 8283 |Claim for Death Benefits |07/1994 |

|National Cemetery Administration |

|40-1330 |Application for Standard Government Monument |05/2008 |

|Miscellaneous |

|SF 180 |Request Pertaining to Military Records |10/2005 |

|DD 149 |Application for Correction of Military or Naval Record |05/2005 |

|DD 293 |Application for the Review of Discharge of Dismissal From the Armed |03/2004 |

| |Forces of the U.S. | |

|DD 1172 |Application for Uniformed Services Identification and Privilege Card |09/2005 |

|IB-10-164 |A Summary of VA Benefits for National Guard and Reserve Personnel |03/2004 |

2. VA Publications and Pamphlets

|Change Date |December 17, 2008 |

|a. Recommended |The following publications and pamphlets should be available for distribution to visitors: |

|Publications and | |

|Pamphlets | |

|Number |Name |Revision Date |

|Compensation and Pension |

|21-00-1 |A Summary of VA Benefits |04/2008 |

|21-03-1 |VA Benefits for Survivors |01/2006 |

|80-08-01 |Federal Benefits for Veterans and Dependents |2008 |

|Education |

|22-05-1 |Reserve Educational Assistance Program (REAP) – Chapter 1607 |12/2005 |

|22-79-1 |Summary of Educational Benefits Under the Post Vietnam Era Vet |02/2004 |

| |Educational Assistance Program | |

|22-90-2 |Summary of Educational Benefits Under the Montgomery GI Bill Active Duty|03/2007 |

| |Educational Assistance Program | |

|22-90-3 |Summary of Educational Benefits Under the Montgomery GI Bill Selected |01/2007 |

| |Reserve Educational Assistance Program | |

Continued on next page

2. VA Publications and Pamphlets, Continued

|a. Recommended Publications and Pamphlets (continued) |

|Number |Name |Revision Date |

|Loan Guaranty |

|26-4 |VA Guaranteed Home Loans for Veterans |02/2005 |

|26-6 |To the Home Buying Veteran |12/2005 |

|26-71-1 |Q&A on Manufactured Home Loans for Veterans |12/2005 |

|26-91-1 |A Quick Guide for Homebuyers and Real Estate Professionals |02/2005 |

|Vocational Rehabilitation & Employment |

|28-01-1 |Vocational Rehabilitation and Employment |07/2001 |

|Insurance |

|29-9 |Service Disabled Veteran’s Insurance RH Information and Premium Rates |03/2006 |

|29-14 |Information About Waiver of Premiums |05/2002 |

|29-77-3 |Facts About Beneficiary and Options |05/1990 |

3. Web-Based References

|Change Date |December 17, 2008 |

|a. Web-Based Reference |The following table provides a listing, including the appropriate link, to web-based reference sites: |

|Listing | |

|Title |Link |

|Compensation & Pension Service Intranet |C&P Service Intranet Home Page |

|Compensation & Pension Service Manual Rewrite (M21-1MR)|M21-1 Manual Rewrite - M21-1MR Main Site |

|Facilities Locator and Directory |Facilities Locator Home Page - Facilities Locator & |

| |Directory |

|Regional Office (ROs) Desk Reference |Regional Office (ROs) Desk References - Alphabetically |

|Publications Index (References, etc) |Publications Index (References, etc.) |

|Compensation & Pension Service User Guides |User Guides |

|Veterans Benefits Reference System (VBRS) |Veterans Benefits Reference System (VBRS) |

|State Benefits Reference System (SBRS) |This program is located off of the VBAPPS menu and can |

| |be installed by your local IRM if you do not have this.|

|Compensation & Pension Service, Direct Services Web |Direct Services Web Site |

|Site | |

|Public Contact Representatives (PCRs) Information – |Public Contact Representatives (PCRs) Information - |

|Alphabetically |Alphabetically |

4. Writing References

|Change Date |December 17, 2008 |

|a. Writing Reference |The following table provides a listing, including the appropriate link, to web-based writing references: |

|Listing | |

|Title/Description |Link |

|Reader-Focused Writing (RFW) Web Site |Reader-Focused Writing |

|RFW Links to Writing Aids, including: |RFW Links |

| | |

|Dictionaries | |

|Grammar References | |

|Style Guides | |

|Thesaurus | |

|General Writing Guides | |

|VA Field Correspondence Guidelines |VA Field Correspondence Guidelines |

|GPO Style Manual |GPO Style Manual: Main Page |

|Elements of Style |Strunk's Elements of Style |

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