VA Form 21-4169 is used to gather information that is necessary to determine eligibility for benefits based on service in the Commonwealth Army of the Philippines or recognized guerrilla organizations, including service information, proof of service, place of residence, and membership in pro-Japanese, pro-German, or anti-American Filipino organizations. Without this information, VA would be unable to properly authorize benefits. VA Form 21-4169 is being revised to include new standardization data points; to include optical character recognition boxes. This is a non-substantive change.
The latest form for Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims) (VA Form 21-4169) expires 2021-03-31 and can be found here.
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Supplementary Document |
Supplementary Document |
Supporting Statement A |