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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.
- VA Form 21P-0969
Get VA Form 21P-0969, Income and Asset Statement in Support...
- IB 10-439 Income Verification Fact Sheet
Income Verification is a process VA uses to match Veterans’...
- VA Form 21P-0969
17 paź 2024 · Get VA Form 21P-0969, Income and Asset Statement in Support of Claim for Pension or Parents’ Dependency and Indemnity Compensation (DIC). Use this VA form if you’ve already filed a DIC claim and want to provide supporting financial evidence.
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.
: VA will compare the information you report on this form to Internal Revenue Service (IRS) and Social Security Administration (SSA) records to verify your income for the past three tax years for which information is available.
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.
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.
21P-0516-1. SUPERSEDES VA FORM 21P-0516-1, JUL 2021, WHICH WILL NOT BE USED. 7A. MONTHLY INCOME (Read Paragraphs 2 and 3 of the EVR Instructions) GROSS MONTHLY AMOUNTS (If no income was received from a particular source, write "0" or "none." VA WILL INTERPRET A BLANK SPACE AS "NONE" or "0.") 7B.
