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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