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 Government Forms |        Most of the forms listed in this topic can be retrieved and printed from the following web site: http://www.va.gov/vaforms. Those forms that cannot be found on the web site may be procured from normal stocking points.  |   
   b. Recommended Forms for Stocking |        The following forms are recommended for 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   Representative  |        11/2005  |   
|     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 Accrued Benefits by Surviving Spouse  |        06/2005  |   
|     21-535  |        Application for Dependency and Indemnity Compensation   by Parent(s) (Including Accrued Benefits & Death Compensation)  |        04/2005  |   
|     21-601  |        Application for Reimbursement From Accrued Amounts Due   a Deceased Beneficiary  |        05/2005  |   
|     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 Children  |        06/2004  |   
|     21-0517  |        Improved Pension Eligibility Verification Report   Veterans with Children  |        06/2004  |   
|     21-0518  |        Improved Pension Eligibility Verification Report   Surviving Spouse with No Children  |        06/2004  |   
|     21-0519  |        Improved Pension Eligibility Verification Report   Surviving Spouse with Children  |        06/2004  |   
|     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 Affairs  |        05/2004  |   
|     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 Surviving Spouses  |        11/2007  |   
|     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 Home Adaptation Grant  |        10/2005  |   
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 Forces of the U.S.  |        03/2004  |   
|     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 Publications and Pamphlets |        The following publications and pamphlets should be available for distribution to visitors: 
  |   
|     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 Educational Assistance Program  |        02/2004  |   
|     22-90-2  |        Summary of Educational Benefits Under the Montgomery GI   Bill Active Duty Educational Assistance Program  |        03/2007  |   
|     22-90-3  |        Summary of Educational Benefits Under the Montgomery GI   Bill Selected Reserve Educational Assistance Program  |        01/2007  |   
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 Listing |        The following table provides a listing, including the appropriate link, to web-based reference sites:  |   
|     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 Site  |        Direct Services Web Site  |   
|     Public Contact Representatives (PCRs) Information – Alphabetically  |        Public Contact Representatives (PCRs) Information - Alphabetically  |   
4. Writing References
   Change Date |        December 17, 2008  |   
   a. Writing Reference Listing |        The following table provides a listing, including the appropriate link, to web-based writing references:  |   
|     Title/Description  |        Link  |   
|     Reader-Focused Writing (RFW) Web Site  |        Reader-Focused Writing  |   
|     RFW Links to Writing Aids, including: · Dictionaries · Grammar References · Style Guides · Thesaurus · General Writing Guides  |        RFW Links  |   
|     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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