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17 sie 2022 · Use this travel reimbursement form (VA Form 10-3542) when you want to ask us to pay you back for travel expenses related to your health care. Downloadable PDF. Download VA Form 10-3542 (PDF) Online tool. You can submit your request online instead of filling out and sending us the paper form. Helpful links related to VA Form 10-3542.
OMB 2900-0798 reference document for Form VA Form 10-3542 VA Form 10-3542 Veteran/Beneficiary Claim for Reimbursement of Travel Ex ... (if no, provide the Street, City, State, Zip below) 3. I am claiming reimbursement of expenses other than mileage, such as tolls, parking, lodging, meals. YES 1.b Date Trip Began (mm/dd/yyyy) 1.c Travel by: (e.g ...
1 lis 2013 · Complete and download the VA Form 10-3542 to claim reimbursement for travel expenses as a veteran or beneficiary. Fill the form online and save as a PDF for easy submission.
8 lut 2024 · OMB Number: 2900-XXXX Estimated Burden: 15 minutes VETERAN/BENEFICIARY CLAIM FOR REIMBURSEMENT OF TRAVEL EXPENSES Section A. Traveler's Information 1.a Name of Person Claiming Travel Reimbursement (Last, First, Middle) 1.b Claimant's SSN 1.c Claimant's Date of Birth (mm/dd/yyyy) 2.a Claimant's status: (check one) Complete 3.a, 3.b, 3.c and 3.d if Caregiver, Attendant or Donor is checked.
VA Form 10-3542. A. Justification. 1. Circumstances Making the Collection of Information Necessary. Through the Beneficiary Travel (BT) program, Veterans Health Administration (VHA) provides mileage reimbursement to qualified Veterans or other claimants (referred to as “claimant” hereafter) who incur expense in traveling to healthcare.
Form VA 10-3542, otherwise known as Veteran Beneficiary Claim for Reimbursement of Travel Expenses, is a form issued by the Department of Veterans Affairs. It allows eligible veterans of the United States army to be reimbursed for their travel expenses.
18 lip 2020 · Use Fill to complete blank online U.S. DEPARTMENT OF VETERANS AFFAIRS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.
