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This form should be used to report or verify income and/or net worth. Changes to income and net worth over multiple years must be reported on a separate VA Form 21P-0969 for each year.
The Eligibility Verification Report (EVR) form will refer you to the instruction paragraphs that apply to you. There are specific instructions for each type of EVR. You can determine what type of EVR you have by looking at the number in the upper right hand corner on the front of this form.
Income Verification is a process VA uses to match Veterans’ gross household income information obtained from the Internal Revenue Service (IRS) and Social Security Administration (SSA). Gross household income includes income of the Veteran, spouse and dependent children.
This form is used by children and custodians of children receiving Old Law or Section 306 Pension. If you have been receiving a fixed rate of pension since 1960, you receive Old Law Pension. If you have been receiving a fixed rate of pension since 1978, you receive Section 306 pension.
Veteran requests for release of IV financial assessments and related information must be forwarded to HEC for processing. The latest form for Health Eligibility Center (HEC) Income Verification (IV) Forms expires 2020-06-30 and can be found here.
It is VHA policy to verify Veterans’ self-reported income (including spouse or partner and dependents, if applicable) for NSC Veterans and non-compensable zero % SC Veterans who have no other special eligibility for receiving VA health care benefits.
If you have a 30% or higher disability rating from VA, you may be eligible for more money to support your family by adding your dependents to your benefits. The fastest way to add a dependent is online through eBenefits at www.eBenefits.va.gov. ELIGIBLE DEPENDENTS. SPOUSE.
