OMB control number
Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966)
OMB 2900-0826 · VA.
OMB 2900-0826
VA Form 21-0966 is used to gather the necessary information to determine an effective date for an award granted in association with a complete claim filed within one year of such form. VA also uses it as a request for application and responds by mailing the claimant a letter of receipt, along with the appropriate VA form or application for VA benefits. Without this information, determination of entitlement would not be possible.
The latest form for Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) expires 2029-05-31 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Form |
 Comment-Response1, VAF21-0966 (2900-0826).docx (document unavailable)Public Comments |
| Comment-Response2, VAF21-0966 (2900-0826) (1).docx (document unavailable) Public Comments |
 30-Day FRN (published) 2900-0826.pdf (document unavailable)Supplementary Document |
Public Comments |
| VA-2025-VACO-0001-0151 2900-0826 1.pdf (document unavailable) Public Comments |
Supplementary Document |
Supporting Statement A |
Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) All Historical Document Collections
| Revision of a currently approved collection | 2026-02-26 | ||
|
Approved without change |
Reinstatement with change of a previously approved collection | 2023-01-17 | |
|
Approved without change |
Extension without change of a currently approved collection | 2018-06-21 | |
|
Approved without change |
Revision of a currently approved collection | 2015-05-22 | |
|
Approved with change |
New collection (Request for a new OMB Control Number) | 2014-07-30 |