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About VA Form 21-10210

Form name: Lay/Witness Statement
Related to: VBA
Form last updated: June 2022

When to use this form

Use VA Form 21-10210 to submit a formal statement to support your VA claim—or the claim of another Veteran or eligible family member.

Downloadable PDF

Download VA Form 21-10210 (PDF)

Online tool

You can submit your statement online instead of sending us the paper form.

Go to the online tool
  • Find out how to update your direct deposit information online for disability compensation, pension, or education benefits.

  • Find out how to change your address and other information in your VA.gov profile for disability compensation, claims and appeals, VA health care, and other benefits.

  • Submit an online request to get your DD214 or other military service records through the milConnect website.

  • Learn how to access your VA records, benefit letters, and documents online.