Income and Asset Statement in Support of Claim for Pension or Parents' DIC (VA Form 21P-0969)

The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services established by law for veterans, service personnel, and their dependents and/or beneficiaries. Information is requested by this form under the authority of: • 38 U.S.C. § 1503 Determinations with respect to annual income • 38 U.S.C. § 1541 Surviving spouses of veterans of a period of war • 38 U.S.C. § 1543 Net worth limitation • 38 U.S.C. § 1315 Dependency and indemnity compensation to parents In RIN 2900-AO73, VA proposes to amend its pension regulations to maintain the integrity of its needs-based pension program. VA has authority under 38 U.S.C. 501(a) to prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by VA. VA would amend its information collections in conjunction with RIN 2900-AO73. This rulemaking is largely in response to a Government Accountability Office (GAO) report, GAO-12-50, Veterans’ Pension Benefits: Improvements Needed to Ensure Only Qualified Veterans and Survivors Receive Benefits. VA Form 21P-0969 will be used by claimants for VA Pension or Parents' Dependency and Indemnity Compensation (DIC) to provide information pertaining to income and assets to establish entitlement to Pension or Parents' DIC. This form will be completed only by those claimants who had income other than Social Security benefits during the calendar year before claiming benefits or who disposed of assets or have significant assets which may affect their entitlement to needs-based benefits.

The latest form for Income and Asset Statement in Support of Claim for Pension or Parents' DIC (VA Form 21P-0969) expires 2021-10-31 and can be found here.