Official VA Form

VA Form 21-0966

Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC

VA Form 21-0966 — Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC is an official U.S. Department of Veterans Affairs form used for disability, family member benefits, pension. The current version was last revised 2023-02-28. It is 2 pages long. Download the up-to-date PDF below — BaseNeed syncs form data directly from VA.gov so you always get the current edition.

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DisabilityFamily member benefitsPension

Frequently asked questions

What is VA Form 21-0966 used for?

Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC. It is an official VA form in the Disability, Family member benefits, Pension categories, administered by VBA.

Where can I download the current VA Form 21-0966?

Download the official PDF from VA.gov here: https://www.vba.va.gov/pubs/forms/VBA-21-0966-ARE.pdf (last revised 2023-02-28).

How long is VA Form 21-0966?

VA Form 21-0966 is 2 pages long, last revised 2023-02-28.

Always the current version — synced from VA.gov. BaseNeed is not affiliated with the U.S. Department of Veterans Affairs.

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