OMB control number

Alternate Signer Certification (VA Form 21-0972)

OMB 2900-0849 · VA.

OMB 2900-0849

VA Form 21-0972 is used to collect the alternate signer information necessary for VA to accept benefit application forms signed by individuals on behalf of Veterans and claimants. The information collected is used to contact the alternate signer for verification purposes. Without this information, VA would be unable to verify information related to the alternate signer who has been appointed to represent the claimant in the prosecution of VA claims, the extent of such representation, and access to appropriate records.

The latest form for Alternate Signer Certification (VA Form 21-0972) expires 2029-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 21-0972 Alternate Signer Certification Form
Public comment for 2900-0849.docx Public Comments
30-Day FRN (published) 2900-0849.pdf Supplementary Document
60-Day FRN (published) 2900-0849.pdf Supplementary Document
2900-0849, Supporting Statement (VAF 21-0972) 1.docx Supporting Statement A
Alternate Signer Certification Form
Alternate Signer Certification Form

All Historical Document Collections

202512-2900-006	Revision of a currently approved collection	2026-02-26
202210-2900-006 Approved without change	Revision of a currently approved collection	2023-01-17
201903-2900-014 Approved without change	Reinstatement without change of a previously approved collection	2019-12-10
201603-2900-010 Approved without change	New collection (Request for a new OMB Control Number)	2016-07-18