Document Name Document Type
Form VA Form 21-0512s-1 Eligibility Verification Reports Form
VA Form 21-0512s-1 Old Law and Section 306 Eligibility Verification Report 21-0512s-1.pdf www.va.gov/vaforms Form
VA Form 21-0512v-1 Old Law and Section 306 Eligibility Verification Report 21-0512v-1.pdf www.va.gov/vaforms Form
VA Form 21-0513-1 Old Law and Section 306 Eligibility Verification Report 21-0513-1.pdf www.va.gov/vaforms Form
VA Form 21-0514-1 DIC Parent's Eligibility Verification Report 21-0514-1.pdf www.va.gov/vaforms Form
VA Form 21-0516-1 Improved Pension Eligibility Verification Report 21-0516-1.pdf www.va.gov/vaforms Form
VA Form 21-0518-1 Improved Pension Eligibility Verification Report (Surviv 21-0518-1.pdf www.va.gov/vaforms Form
VA Form 21-0519c-1 Improved Pension Eligibility Verification Report (Child 21-0519c-1.pdf www.va.gov/vaforms Form
VA Form 21-0519s-1 Improved Pension Eligibility Verification Report (Surviv 21-0519s-1.pdf www.va.gov/vaforms Form
VA Form 21-0517-1 Improved Pension Eligibility Verification Report -Vetera 21-0517-1.pdf www.va.gov/vaforms Form
VA Form 21-0519c Improved Pension Eligibility Report (Child or Children) 21-0519c.pdf This form is available from the VAITC in Hines, Il Form
VA Form 21-0519s Improved Pension Eligibility Verification Report - Survi 21-0519s.pdf This form is available from the VA ITC in Hines, Il Form
VA Form 21-0514 DIC Parent's Eligibility Verification Report 21-0514.pdf This form is available from the VAITC at Hines, Il Form
VA Form 21-0516 Improved Pension Eligibility Report - Veteran With No Ch 21-0516.pdf This form is available from the VAITC in Hines, IL Form
VA Form 21-0517 Improved Pension Eligibility Verification Report - Veter 21-0517.pdf This form is available from the VAITC in Hines, IL Form
VA Form 21-0518 Improved Pension Eligibility Report - Surviving Spouse W 21-0518.pdf This form is available from the VAITC in Hines, IL Form
VA Form 21-0510 Eligibility Verification Report Instructions 21-0510.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Eligibility Verification Reports	Agency IC Tracking Number:	2900-0101

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.256 38 CFR 3.277

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21-0512s-1	Old Law and Section 306 Eligibility Verification Report (Surviving Spouse)	21-0512s-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0514-1	DIC Parent's Eligibility Verification Report	21-0514-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0516-1	Improved Pension Eligibility Verification Report	21-0516-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0518-1	Improved Pension Eligibility Verification Report (Surviving Spouse with No Children)	21-0518-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0519c-1	Improved Pension Eligibility Verification Report (Child or Children)	21-0519c-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0519s-1	Improved Pension Eligibility Verification Report (Surviving Spouse with Children)	21-0519s-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0517-1	Improved Pension Eligibility Verification Report -Veteran With Children	21-0517-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0519c	Improved Pension Eligibility Report (Child or Children)	21-0519c.pdf	This form is available from the VAITC in Hines, Il	No		Paper Only
Form	VA Form 21-0519s	Improved Pension Eligibility Verification Report - Surviving Spouse With Children	21-0519s.pdf	This form is available from the VA ITC in Hines, Il	No		Paper Only
Form	VA Form 21-0514	DIC Parent's Eligibility Verification Report	21-0514.pdf	This form is available from the VAITC at Hines, Il	No		Paper Only
Form	VA Form 21-0516	Improved Pension Eligibility Report - Veteran With No Children	21-0516.pdf	This form is available from the VAITC in Hines, IL	No		Paper Only
Form	VA Form 21-0517	Improved Pension Eligibility Verification Report - Veteran With Children	21-0517.pdf	This form is available from the VAITC in Hines, IL	No		Paper Only
Form	VA Form 21-0518	Improved Pension Eligibility Report - Surviving Spouse With No Children	21-0518.pdf	This form is available from the VAITC in Hines, IL	No		Paper Only
Form	VA Form 21-0510	Eligibility Verification Report Instructions	21-0510.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0513-1	Old Law and Section 306 Eligibility Verification Report (Children Only)	21-0513-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21-0512v-1	Old Law and Section 306 Eligibility Verification Report (Veteran)	21-0512v-1.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 219,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	219,000	219,000
Annual IC Time Burden (Hours)	113,075	113,075
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

Eligibility Verification Reports

Eligibility Verification Reports

OMB: 2900-0101

IC ID: 28278

View Information Collection (IC)