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About VA Form 21P-0969

Form name: Income and Asset Statement in Support of Claim for Pension or Parents' Dependency and Indemnity Compensation (DIC)
Related to: Disability, Family member benefits, Pension, Service member benefits
Form last updated: February 2024

When to use this form

VA Form 21P-0969 is an attachment to other forms, and is used to provide supporting financial evidence. Use VA Form 21P-0969 only if you’re instructed to, when you’re completing VA form 21P-527, 21P-527EZ, 21P-534, or 21P-534EZ.

Downloadable PDF

Download VA Form 21P-0969 (PDF)
  • VA Form 21P-534

    Form name: Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)

    Use VA Form 21P-534 if you prefer to provide evidence at a later time to support your claim. You can use this form if you’re a surviving spouse or child of a Veteran who has died and want to begin the process of applying for VA benefits or money that we owe the Veteran but did not pay prior to his or her death.

    Download VA Form 21P-534 (PDF)
  • VA Form 21P-534EZ

    Form name: Application for DIC, Survivors Pension, and/or Accrued Benefits

    Use VA Form 21P-534EZ if you want to submit evidence along with your claim, using the Fully Developed Claim (FDC) program to get a decision on your claim faster. You can use this form if you’re:

    • A surviving spouse or child of a Veteran who has died
    • Applying for VA benefits and/or the money that we owe the Veteran but didn’t pay prior to their death (accrued benefits)
    • Using the Fully Developed Claim (FDC) program to get a decision on your claim faster by submitting evidence along with your claim
    Download VA Form 21P-534EZ (PDF)
  • VA Form 21P-527

    Form name: Income, Net Worth, and Employment Statement

    Use this VA form if you’ve already filed a claim for pension benefits and you’re adding financial evidence to your existing claim. Note: If you have not filed a claim yet, use VA Form 21P-527EZ instead.

    Download VA Form 21P-527 (PDF)
  • VA Form 21P-527EZ

    Form name: Application for Veterans Pension

    Use VA Form 21P-527EZ if you’re a wartime Veteran and want to file a pension claim. 

    Download VA Form 21P-527EZ (PDF)
  • As the surviving spouse, child, or parent of a service member who died in the line of duty, or the survivor of a Veteran who died from a service-related injury or illness, you may be eligible for DIC payments.