VA Form 21-526EZ Notice to Veteran/Service Member of Evidence Necessary to Substantiate a Claim for Veterans Disability Compensation and Related Compensation Benefits

What Is VA 21-526EZ?

VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits is a form used for filing a сlaim for veteran's disability compensation or other related benefits under the Fully Developed Claim program (FDC).

The latest version of the form was released by the Department of Veteran Affairs (VA) in March 2018, with the existing stock of previous editions used. A fillable VA Form 21-526EZ is available for digital filing and download below or can be found through the VA website.

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NOTICE TO VETERAN/SERVICE MEMBER OF EVIDENCE NECESSARY TO SUBSTANTIATE A
CLAIM FOR VETERANS DISABILITY COMPENSATION
AND RELATED COMPENSATION BENEFITS
This notice provides information regarding the evidence necessary to substantiate a claim for:
• Disability Service Connection
• Compensation Claims Submitted Prior to Discharge
• Compensation under 38 U.S.C. 1151
• Automobile Allowance/Adaptive Equipment
• Secondary Service Compensation
• Temporary Total Disability Rating
• Special Monthly Compensation
• Benefits Based on a Veteran's Seriously Disabled Child
• Increased Disability Compensation
• Individual Unemployability
• Specially Adapted Housing/Special Home Adaptation
Use this notice and the attached application to submit a claim for veterans' disability compensation and related compensation benefits. This notice
informs you of the evidence necessary to decide your claim. After you submit your claim on the attached application you will not receive an initial letter
regarding your claim. You do not need to submit another application.
Want to apply electronically? You can apply for VA disability compensation and pension online through eBenefits at www.ebenefits.va.gov. For
disability compensation claims, you can also upload all supporting evidence you may have and make your claim a Fully Developed Claim (FDC). To file
a claim for VA disability compensation electronically, go to eBenefits, select Apply for Benefits and then Apply for Disability Compensation. You will
need to create an eBenefits account to apply for disability compensation online. To file a claim for VA pension electronically, go to eBenefits, select
Apply for Benefits, and then select Apply for Veterans Benefits via VONAPP. Once you submit your claim, you can track the status using eBenefits.
NOTE: You may wish to contact an accredited veterans service officer (VSO) to assist you with your application. For a list of accredited veterans
service organizations go to https://www.va.gov/vso/. You may also contact your state office of veterans affairs at https://www.va.gov/statedva.htm,
should you need further assistance with the application process.
Want your claim processed faster? The FDC Program is the fastest way to get your claim processed and there is no risk to participate! To participate
in the FDC Program, if you are making a claim for veterans disability compensation or related compensation benefits, simply submit your claim in
accordance with the "FDC Criteria" shown below. If you are making a claim for veterans non service-connected pension benefits, use VA Form
21P-527EZ, Application for Pension. If you are making a claim for survivor benefits, use VA Form 21P-534EZ, Application for DIC, Death Pension,
and/or Accrued Benefits. VA forms are available at www.va.gov/vaforms. A separate expedited claims processing program available for current active
duty Servicemembers is explained on page 5 under Compensation Claims Submitted Prior to Discharge.
NOTE: Participation in the FDC Program is optional and will not affect the benefits to which you are entitled. If you file a claim in the FDC Program
and it is determined that other records exist and VA needs the records to decide your claim, then VA will simply remove the claim from the FDC
Program (Optional Expedited Process) and process it in the Standard Claim Process. See below for more information. If you wish to file your claim in
the FDC Program, see FDC Program (Optional Expedited Process). If you wish to file your claim under the process in which VA traditionally processes
claims, see Standard Claim Process.
SUBMITTING A CLAIM
When submitting a claim(s) for Veterans Disability Compensation and Related Compensation Benefits the following information tells you
what you need to do and what VA will do during the FDC Program (Optional Expedited Process) or the Standard Claim Process:
1. HOW TO SUBMIT A CLAIM
Submit your claim on a VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits (Attached). Make
sure you complete and sign your application.
2. WHAT YOU NEED TO DO
The table on page 2 describes the information and evidence you need to submit based on whether you wish to have your claim considered in the
FDC Program (Optional Expedited Process) or in the Standard Claim Process. You will need to indicate how you want your claim to be processed
by checking the appropriate box in Item 1, on page 8 of this form.
VA FORM
21-526EZ
EXISTING STOCK OF VA FORM 21-526EZ, FEB 2016,
Page 1
MAR 2018
WILL BE USED.
NOTICE TO VETERAN/SERVICE MEMBER OF EVIDENCE NECESSARY TO SUBSTANTIATE A
CLAIM FOR VETERANS DISABILITY COMPENSATION
AND RELATED COMPENSATION BENEFITS
This notice provides information regarding the evidence necessary to substantiate a claim for:
• Disability Service Connection
• Compensation Claims Submitted Prior to Discharge
• Compensation under 38 U.S.C. 1151
• Automobile Allowance/Adaptive Equipment
• Secondary Service Compensation
• Temporary Total Disability Rating
• Special Monthly Compensation
• Benefits Based on a Veteran's Seriously Disabled Child
• Increased Disability Compensation
• Individual Unemployability
• Specially Adapted Housing/Special Home Adaptation
Use this notice and the attached application to submit a claim for veterans' disability compensation and related compensation benefits. This notice
informs you of the evidence necessary to decide your claim. After you submit your claim on the attached application you will not receive an initial letter
regarding your claim. You do not need to submit another application.
Want to apply electronically? You can apply for VA disability compensation and pension online through eBenefits at www.ebenefits.va.gov. For
disability compensation claims, you can also upload all supporting evidence you may have and make your claim a Fully Developed Claim (FDC). To file
a claim for VA disability compensation electronically, go to eBenefits, select Apply for Benefits and then Apply for Disability Compensation. You will
need to create an eBenefits account to apply for disability compensation online. To file a claim for VA pension electronically, go to eBenefits, select
Apply for Benefits, and then select Apply for Veterans Benefits via VONAPP. Once you submit your claim, you can track the status using eBenefits.
NOTE: You may wish to contact an accredited veterans service officer (VSO) to assist you with your application. For a list of accredited veterans
service organizations go to https://www.va.gov/vso/. You may also contact your state office of veterans affairs at https://www.va.gov/statedva.htm,
should you need further assistance with the application process.
Want your claim processed faster? The FDC Program is the fastest way to get your claim processed and there is no risk to participate! To participate
in the FDC Program, if you are making a claim for veterans disability compensation or related compensation benefits, simply submit your claim in
accordance with the "FDC Criteria" shown below. If you are making a claim for veterans non service-connected pension benefits, use VA Form
21P-527EZ, Application for Pension. If you are making a claim for survivor benefits, use VA Form 21P-534EZ, Application for DIC, Death Pension,
and/or Accrued Benefits. VA forms are available at www.va.gov/vaforms. A separate expedited claims processing program available for current active
duty Servicemembers is explained on page 5 under Compensation Claims Submitted Prior to Discharge.
NOTE: Participation in the FDC Program is optional and will not affect the benefits to which you are entitled. If you file a claim in the FDC Program
and it is determined that other records exist and VA needs the records to decide your claim, then VA will simply remove the claim from the FDC
Program (Optional Expedited Process) and process it in the Standard Claim Process. See below for more information. If you wish to file your claim in
the FDC Program, see FDC Program (Optional Expedited Process). If you wish to file your claim under the process in which VA traditionally processes
claims, see Standard Claim Process.
SUBMITTING A CLAIM
When submitting a claim(s) for Veterans Disability Compensation and Related Compensation Benefits the following information tells you
what you need to do and what VA will do during the FDC Program (Optional Expedited Process) or the Standard Claim Process:
1. HOW TO SUBMIT A CLAIM
Submit your claim on a VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits (Attached). Make
sure you complete and sign your application.
2. WHAT YOU NEED TO DO
The table on page 2 describes the information and evidence you need to submit based on whether you wish to have your claim considered in the
FDC Program (Optional Expedited Process) or in the Standard Claim Process. You will need to indicate how you want your claim to be processed
by checking the appropriate box in Item 1, on page 8 of this form.
VA FORM
21-526EZ
EXISTING STOCK OF VA FORM 21-526EZ, FEB 2016,
Page 1
MAR 2018
WILL BE USED.
Standard Claim Process
FDC Program (Optional Expedited Process)
If you know of evidence not in your possession and want VA
You must:
to try to get it for you;
• Submit all relevant private treatment records, if they exist
You must:
• Identify any relevant treatment records available at a Federal
• Complete and sign VA Form 21-4142, Authorization to
Facility, such as a VA medical center
Disclose Information to the Department of Veterans Affairs
(VA) and VA Form 21-4142a, General Release for Medical
• Identify the location and sufficient information to obtain
Provider Information to the Department of Veterans Affairs
your National Guard and Reserve personnel and service
(VA), identifying any private medical records you wish VA
treatment records (if applicable)
to request for you
If your claim involves a disability that you had before entering
• Give VA enough information about other relevant evidence
service and that was made worse by service, please provide
so that we can request it from the person or agency that has it
any information or evidence in your possession regarding the
health condition that existed before your entry into service.
If the holder of the evidence declines to give it to VA, asks for a
fee to provide it, or otherwise cannot get the evidence, VA will
NOTE: If you decide to submit your claim through the FDC
notify you and provide you with an opportunity to submit the
Program, please indicate FDC in Item 1 of the application on
information or evidence. It is your responsibility to make sure
page 8.
we receive all requested records that are not in the possession
of a Federal department or agency.
If your claim involves a disability that you had before entering
service and that was made worse by service, please provide
any information or evidence in your possession regarding the
health condition that existed before your entry into service.
You must:
You are strongly encouraged to:
• Send the information and evidence along with your claim
• Send any information or evidence as soon as you can
If you submit additional information or evidence after you
You have up to one year from the date we receive the claim to
submit your "fully developed" claim, then VA will remove the
submit the information and evidence necessary to support your
claim from the FDC Program (Optional Expedited Process)
claim. If within 30 days, you do not provide any evidence or do
and process it in the Standard Claim Process. If we decide your
not provide us with the information needed to assist you with
claim before one year from the date we receive the claim, you
obtaining evidence, we may decide your claim prior to the
will still have the remainder of the one-year period to submit
expiration of the one year period. If we decide the claim before
additional information or evidence necessary to support the
one year from the date we receive the claim, you will still have
claim.
the remainder of the one year period to submit additional
information or evidence necessary to support the claim.
If any of the special circumstances in the table below titled "Special
If any of the special circumstances in the table below titled "Special
Circumstances" applies to you;
Circumstances" applies to you;
You must:
You are strongly encouraged to:
• Send the information and evidence identified in the "Special
• Send the information and evidence identified in the "Special
Circumstances" table below at the same time as your claim
Circumstances" table below at the same time as your claim.
If you do not submit the needed information or evidence with
your claim but it is needed to make a decision, VA will request
it from you.
SPECIAL CIRCUMSTANCES
Under the special circumstances shown below, you must also submit along with your claim the following:
• If you were treated at a Veterans Center, submit a completed VA Form 21-4142
• If claiming dependents, submit a completed VA Form 21-686c, Declaration of Status of Dependents. If claiming a child in
school between the ages of 18 and 23; also submit a completed VA Form 21-674, Request for Approval of School Attendance.
If claiming benefits for a seriously disabled (helpless) child, also submit all, relevant, private medical treatment records
pertaining to the child's pertinent disabilities
• If claiming Individual Unemployability, submit a completed VA Form 21-8940, Veteran's Application for Increased Compensation Based
on Unemployability
• If claiming Post-Traumatic Stress Disorder (PTSD), submit a completed VA Form 21-0781, Statement in Support of Claim for Service
Connection for Post-Traumatic Stress Disorder, or if claiming PTSD based on personal assault, submit a completed VA Form 21-0781a,
Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder Secondary to Personal Assault
Page 2
VA FORM 21-526EZ, MAR 2018
SPECIAL CIRCUMSTANCES (Continued)
Under the special circumstances shown below, you must also submit along with your claim the following:
• If claiming Specially Adapted Housing or Special Home Adaptation, submit a completed VA Form 26-4555, Application in Acquiring
Specially Adapted Housing or Special Home Adaptation Grant
• If claiming Auto Allowance, submit a completed VA Form 21-4502, Application for Automobile or Other Conveyance and Adaptive
Equipment
• If claiming additional benefits because you or your spouse require Aid and Attendance, submit a completed VA Form 21-2680,
Examination for Housebound Status or Permanent Need for Regular Aid and Attendance; or if claiming Aid and Attendance based on
nursing home attendance, a VA Form 21-0779, Request for Nursing Home Information in Connection with Claim for Aid and Attendance
NOTE: VA forms are available online at www.va.gov/vaforms.
3. HOW VA WILL HELP YOU OBTAIN EVIDENCE FOR YOUR CLAIM
The table below describes the information and evidence VA will assist you in obtaining based on whether you wish to have your claim considered
in the FDC Program (Optional Expedited Process) or in the Standard Claim Process.
FDC Program (Optional Expedited Process)
Standard Claim Process
VA will:
VA will:
• Retrieve relevant records from a Federal facility, such as
• Retrieve relevant records from a Federal facility, such as
a VA medical center, that you adequately identify and
a VA medical center, that you adequately identify and
authorized VA to obtain
authorized VA to obtain
• Provide a medical examination for you, or get a medical
• Provide a medical examination for you, or get a medical
opinion, if we determine it is necessary to decide your claim
opinion, if we determine it is necessary to decide your claim
• Make every reasonable effort to obtain relevant records not
held by a Federal facility that you adequately identify and
authorize VA to obtain. These may include records from State
or local governments and privately held evidence and information
you tell us about, such as a private doctor or hospital records
from current or former employers
4. WHERE TO SEND INFORMATION AND EVIDENCE
You may send your application and any evidence in support of your claim by using any of the following methods shown in the table below.
MAIL TO
FAX TO
ONLINE
Department of Veterans Affairs
Evidence Intake Center
844-531-7818 (Toll Free) OR
www.ebenefits.gov
PO Box 4444
For Foreign Claims 248-524-4260
Janesville, WI 53547-4444
5. WHAT THE EVIDENCE MUST SHOW TO SUPPORT YOUR CLAIM
The table below provides a guide to the evidence tables showing what evidence you must provide to support your claim.
If you are claiming...
See the evidence table titled...
You have a disability that was caused or aggravated by your service
Disability Service Connection
Your service connected disability caused or aggravated an additional
Secondary Service Connection
disability
Your service connected disability has worsened
Increased Disability Compensation
Compensation and you are a serviceperson who is about to be discharged
Compensation Claims Submitted Prior to Discharge
Your service connected disability caused you to be hospitalized or to
Temporary Total Disability Rating
undergo surgery or other treatment
Your service connected disability(ies) prevents you from getting or
Individual Unemployability
keeping substantial employment
You have a disability caused or aggravated by VA medical treatment,
Compensation Under 38 U.S.C. 1151
vocational rehabilitation, or compensated work therapy
Page 3
VA FORM 21-526EZ, MAR 2018
5. WHAT THE EVIDENCE MUST SHOW TO SUPPORT YOUR CLAIM (Continued)
The table below provides a guide to the evidence tables showing what evidence you must provide to support your claim.
If you are claiming...
See the evidence table titled...
Your service connected disability (ies) causes you to be in need of aid and
Special Monthly Compensation
attendance or to be confined to your residence
Adapting and/or purchasing a residence
Special Adapted Housing or Special Home Adaptation
Adapting and/or purchasing a vehicle
Auto Allowance
A Severely Disabled Spouse
Special Monthly Compensation
A Severely Disabled Child
Helpless Child
EVIDENCE TABLES
Disability Service Connection
To support a claim for service connection, the evidence must show:
• You had an injury in service, or a disease that began in or was made permanently worse during service, or there was an event in service that
caused an injury or disease; AND
• You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and recurrent
symptoms of disability that are visible or observable; AND
• A relationship exists between your current disability and an injury, disease, symptoms, or event in service. This may be shown by medical
records or medical opinions or, in certain cases, by lay evidence.
However, under certain circumstances, VA may presume that certain current disabilities were caused by service, even if there is no specific
evidence proving this in your particular claim. The cause of a disability is presumed for the following veterans who have certain diseases:
• Former prisoners of war;
• Veterans who have certain chronic or tropical diseases that become evident within a specific period of time after discharge from service;
• Veterans who were exposed to ionizing radiation, mustard gas, or Lewisite while in service;
• Veterans who were exposed to certain herbicides, such as by serving in Vietnam; or
• Veterans who served at Camp Lejeune for no less than 30 days (consecutive or nonconsecutive) between August 1, 1953 and
December 31, 1987; or
• Veterans who served in the Southwest Asia theater of operations during the Gulf War.
To support a claim for service connection based upon a period of active duty for training, the evidence must show:
• You were disabled during active duty for training due to disease or injury incurred or aggravated in the line of duty; AND
• You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and
recurrent symptoms of disability that are visible or observable; AND
• There is a relationship between your current disability and the disease or injury incurred or aggravated during active duty
for training. This may be shown by medical records or medical opinions or, in certain cases, by lay evidence.
To support a claim for service connection based upon a period of inactive duty training, the evidence must show:
• You were disabled during inactive duty training due to an injury incurred or aggravated in the line of duty or an acute myocardial
infarction, cardiac arrest, or cerebrovascular accident during inactive duty training; AND
• You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and
recurrent symptoms of disability that are visible or observable; AND
• There is a relationship between your current disability and your inactive duty training. This may be shown by medical records or
medical opinions or, in certain cases, by lay evidence.
In order to reopen a claim previously denied by VA, we need new and material evidence. New and material evidence must raise a reasonable
possibility of substantiating your claim. The evidence cannot simply be repetitive or cumulative of the evidence we had when we previously
decided your claim. VA will make reasonable efforts to help you obtain currently existing evidence. However, we cannot provide a medical
examination or obtain a medical opinion until your claim is successfully reopened.
• To qualify as new, the evidence must currently exist and be submitted to VA for the first time.
• In order to be considered material, the additional existing evidence must pertain to the reason your claim was previously denied.
Secondary Service Connection
To support a claim for compensation based upon an additional disability that was caused or aggravated by a service-connected disability, the
evidence must show:
• You currently have a physical or mental disability shown by medical evidence or by lay evidence of persistent and recurrent symptoms of
disability that are visible or observable, in addition to your service-connected disability; AND
• Your service-connected disability either caused or aggravated your additional disability. This may be shown by medical records or medical
opinions or, in certain cases, by lay evidence. However, VA may presume service-connection for cardiovascular disease developing in a
claimant with certain service-connected amputation(s) of one or both lower extremities.
Page 4
VA FORM 21-526EZ, MAR 2018
EVIDENCE TABLES (Continued)
Increased Disability Compensation
If VA previously granted service connection for your disability and you are seeking an increased evaluation of your service-connected disability,
we need medical or lay evidence to show a worsening or increase in severity and the effect that worsening or increase has on your ability to work.
Compensation Claims Submitted Prior to Discharge
Under the Benefits Delivery at Discharge (BDD) program you can submit a disability claim 90 to 180 days prior to your anticipated separation date
from active duty. Claims are accepted from active duty Servicemembers, including reservists serving on active duty in an Active Guard Reserve
(AGR) role under 10 U.S.C. and full-time National Guard members serving in an AGR role under 32 U.S.C.
BDD program participants can have their VA medical examinations conducted while they are still on active duty. You are encouraged to
file your claim as close to the 180 day mark as possible to ensure your examinations can be scheduled and completed prior to your discharge from
active duty. The BDD program requires that Servicemembers be available to report for examinations for 45 days following submission of a disability
claim. Claims and additional contentions received with less than 90 days remaining on active duty, claim types that are excluded from the BDD
program, or where the Servicemember is unable to report for an examination within the BDD required time frame will be processed under the
standard VA claims process, the Fully Developed Claim (FDC) program or any other qualifying program.
BDD Program Criteria for Claim(s) for Disability Compensation and Related Compensation Benefits Submitted Prior to Separation from
Active Duty:
• be within 90 to 180 days of discharge;
• be available to report for examinations for 45 days following the submission of a disability claim;
• provide an anticipated release from active duty date, and
• complete a VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits
Temporary Total Disability Rating
In order to support a claim for a temporary total disability rating due to hospitalization, the evidence must show:
• You were treated for more than 21 days for a service-connected disability at a VA or other approved hospital; OR
• You underwent hospital observation at VA expense for a service-connected disability for more than 21 days.
In order to support a claim for a temporary total disability rating due to surgical or other treatment performed by a VA or other approved
hospital or outpatient facility, the evidence must show:
• The surgery or treatment was for a service-connected disability; AND
• The surgery required convalescence of at least one month; OR
• The surgery resulted in severe postoperative residuals, such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic
immobilizations, house confinement, or the required use of a wheelchair or crutches; OR
• One major joint or more was immobilized by a cast without surgery.
Individual Unemployability
In order to support a claim for a total disability rating based on individual unemployability, the evidence must show:
• That your service-connected disability or disabilities are sufficient, without regard to other factors, to prevent you from performing the mental
and/or physical tasks required to get or keep substantially gainful employment; AND
• Generally, you meet certain disability percentage requirements as specified in 38 Code of Federal Regulations 4.16 (i.e. one disability ratable at
60 percent or more, OR more than one disability with one disability ratable at 40 percent or more and a combined rating of 70 percent or
more).
In order to support a claim for an extra-schedular evaluation based on exceptional circumstances, the evidence must show:
• That your service-connected disability or disabilities present such an exceptional or unusual disability picture, due to such factors as marked
interference with employment or frequent periods of hospitalization, that application of the regular schedular standards is impractical.
Compensation Under 38 U.S.C. 1151
In order to support a claim for compensation under 38 U.S.C. 1151, the evidence must show that, as a result of VA hospitalization, medical or
surgical treatment, examination, or training, you have:
• An additional disability or disabilities; OR
• An aggravation of an existing injury or disease; AND
• The disability was the direct result of VA fault such as carelessness, negligence, lack of proper skill, or error in judgment, or not a reasonably
expected result or complication of the VA care or treatment; OR
• The direct result of participation in a VA Vocational Rehabilitation and Employment or compensated work therapy program.
Page 5
VA FORM 21-526EZ, MAR 2018

Download VA Form 21-526EZ Notice to Veteran/Service Member of Evidence Necessary to Substantiate a Claim for Veterans Disability Compensation and Related Compensation Benefits

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What Is VA Form 21-526EZ Used for?

The application can be used to claim one of the following benefits:

  • Disability Service Connection;
  • Compensation Claims Submitted Prior to Discharge;
  • Compensation under 38 U.S.C. 1151;
  • Automobile Allowance/Adaptive Equipment;
  • Secondary Service Compensation;
  • Temporary Total Disability Rating;
  • Special Monthly Compensation;
  • Benefits Based on a Veteran's Seriously Disabled Child;
  • Increased Disability Compensation;
  • Individual Unemployability especially Adapted Housing/Special Home Adaptation.

VA Form 21-526EZ Instructions

VA Form 21-526EZ consists of twelve pages. The form guidelines are provided on the first seven pages. The instructions for filling out the form are below.

How to Fill out VA Form 21-526EZ?

  1. Select the Claim program type.
  2. Section I. Identification information. Include your name, social security number, VA number if any, date of birth, veteran service number, and gender, as well as your contact details. If the form is used for Benefits Delivery at Discharge (BDD), this section should include the date or anticipated date of release from active duty. Indicate your employment if you are a current VA employee.
  3. Section II. Change of Address information. If you anticipate a change of address, do mention it in this section.
  4. Section III. Homeless information. This section is filled out if you are homeless or at risk of being homeless. Otherwise, leave it blank.
  5. Section IV. Claim information. Provide all your current disabilities and treatment facilities, where you received treatment.
  6. Section V. Service data. Include the branch and component of service, the most recent active service dates, whether you served in reserves or national guard, or are on active duty. If you have served in a combat zone since 9/11/2001 or have ever been a prisoner of war, indicate it in this section.
  7. Section VI. Service pay information. Provide data about all military payments you receive, and whether you want to receive the VA compensation in lieu of military retired pay or training pay or not.
  8. Section VII. Direct deposit information.
  9. Section VIII. Claiming certification and your signature.
  10. Section IX. Signatures of witnesses.
  11. Section X. Alternate signer certification and signature.
  12. Section XI. Power of attorney signature.

VA 21-526EZ Related Forms

VA 21-526EZ Form belongs to VA 21-526 series. The other forms of the series are:

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