VA Form 21-534A Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - in-Service Death Only

What Is VA Form 21-534A?

VA Form 21-534A, Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In-Service Death Only is a document needed to check the eligibility of surviving spouses and children of veterans who died during active duty service to receive benefits, dependency and indemnity compensation, death compensation, and/or death pension.

The latest version of the VA 21-534A Form was issued by the Department of Veterans Affairs (VA) in June 2014 with all previous editions obsolete. VA Form 21-543A fillable version is available for download below; however, it is no longer used. VA Form 21P-534A has replaced it, and you can download the new form to apply for Dependency and Indemnity below.

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Download VA Form 21-534A Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - in-Service Death Only

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VA Form 21-534A Instructions

  1. State the veteran's full name and social security number (SSN);
  2. Write down your full name, SSN, and date of birth. If you are a surviving spouse, state if you have lived with the veteran to the date of death;
  3. Specify the reason, the date, and the duration of separation if it is applicable;
  4. Write down the deceased veteran's children full names, dates, and places of birth, SSNs, and describe their relationship to you;
  5. Submit your current mailing address and telephone numbers. If the address changes in the future, write down the new address and the date of the change;
  6. State if you wish to receive the VA payment directly to your financial account;
  7. Provide information on your account - its type, number, and the transit number of the financial institution (bank);
  8. Confirm that the form contains only complete and true information to the best of your knowledge and belief;
  9. Sign the form and write down the date.

The last section of the form must be filled out by the Military Casualty Assistance Officer. The VA will assign the CAO to you in order to help you complete and submit the form. The CAO will write down the full name, the rank, the telephone number, and the e-mail address at the bottom of the document.

VA 21-534A Related Forms

VA Form 21-534, Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits a Surviving Spouse or Child (Including Death Compensation if Applicable) is a related form submitted by a surviving spouse or child of a veteran to apply for various VA benefits and financial assistance the VA owes the deceased veteran. Unlike the previous form, this document is used when the death of the veteran occurred on active service, or as a result of a service-connected disability or a non-service connected injury during the time when the veteran was receiving VA compensation for a service-connected disability.

VA Form 21-534EZ, Application for DIC, Death Pension, and/or Accrued Benefits is a related document completed by a surviving spouse or child to submit required evidence and information to justify and rationalize a claim for accrued benefits, dependency and indemnity compensation, or survivors pension.