Department of Veterans Affairs (VA, VBA, SGLV & VAF) Forms in Microsoft Word - Page 1 of 2

VA 3542 Form

Authorization to Report - Voucher for Mileage Allowance

$12.99

VA 10-0094a Form

Medical Education Affiliation Agreement - School of Medicine

$12.99

VA 10-0094b Form

Medical Education Affiliation Agreement - Osteopathic Medicine

$12.99

VA 10-0094c Form

Medical Education Affiliation Agreement - Graduate Medical Education

$12.99

VA 10-0094d Form

Medical Education Affiliation Agreement - School of Dentistry

$12.99

VA 10-0094e Form

Medical Education Affiliation Agreement - VA Sponsor - Dentistry

$12.99

VA 10-0094f Form

Dental Education Affiliation Agreement

$12.99

VA 10-0094g Form

Associated Health Education Affiliation Agreement

$12.99

VA 10-0094h Form

Education Affiliation Agreement - Non-VA Health Care Facility

$12.99

VA 10-0102 Form

CAREER DEVELOPMENT APPLICATION

$12.99

VA 10-0137 Form

VA Advance Directive: Living Will & Durable Power of Attorney for Health Care

$12.99

VA 10-0137A Form

Your Rights Regarding Advance Directives

$12.99

VA 10-0137B Form

WHAT YOU SHOULD KNOW ABOUT ADVANCE DIRECTIVES

$12.99

VA 10-0143 Form

Certification Regarding Drug-Free Workplace

$12.99

VA 10-0143a Form

Statement of Assurance of Compliance with Sec. 504 of the Rehabilitation Act

$12.99

VA 10-0144 Form

Certification Regarding Lobbying

$12.99

VA 10-0144a Form

Statement of Assurance of Compliance with Equal Opportunity Laws- fillable

$12.99

VA 10-0361 Form

Homeless Providers Grant and Per Diem Program

$12.99

VA 10-0376a Form

Credentials Transfer Brief - Fillable

$12.99

VA 10-0379 Form

Ecclesiastical Endorsing Organization Verification/Reverification Info. - fill

$12.99

VA 10-0381 Form

Civil Rights Discrimination Complaint - Fillable

$12.99

VA 10-0388 Form

Documents & Information Required for State Home Construction & Acquisition Grant

$12.99

VA 10-0388-1 Form

Initial Application for State Home Construction & Acquisition

$12.99

VA 10-0388-10 Form

Cert. of Compliance with Federal Requirements - State Home Construction Grant

$12.99

VA 10-0388-11 Form

Memorandum of Agreement for a Grant to Construct or Acquire State Veterans Home

$12.99

VA 10-0388-12 Form

Cert Re Debarment, Suspension, Ineligibility, Voluntary Exclusn-Lower Tier Tran

$12.99

VA 10-0388-13 Form

Docs & Info Required for State Home Construction/Acquisition-Post Grant Requir's

$12.99

VA 10-0388-14 Form

Checklist of Major Requirements for State Home Construction/Acquisition Grants

$12.99

VA 10-0388-2 Form

Cert. of Compliance w/ the Provisions of Davis-Bacon Act (40 USC 276a to 276a-7)

$12.99

VA 10-0388-3 Form

State Home Construction Grant Program Space Program Analysis-Nursing Home & Dom

$12.99

VA 10-0388-4 Form

State Home Construction Grant Program-Adult Day Health Care

$12.99

VA 10-0388-5 Form

Add'l. Doc's. & Info. Required-State Home Construction /Acquisition Grants Appl.

$12.99

VA 10-0388-6 Form

Certification of State Matching Funds to Qualify for Group 1 on Priority List

$12.99

VA 10-0388-7 Form

Cert. Re Debarment, Suspension, Other ...-Primary Covered Transactions

$12.99

VA 10-0388-8 Form

Cert. Re Drug-Free Workplace Requirments for Grantees Other than Individuals

$12.99

VA 10-0388-9 Form

Certification Regarding Lobbying

$12.99

VA 10-0398 Form

Research Protocol Safety Survey

$12.99

VA 10-0400 Form

Request for VSO Access to CPRS (Computer Patient Record System)

$12.99

VA 10-0400a Form

CPRS Read-Only Rules for VSOs

$12.99

VA 10-0408 Form

VHA Fisher House Application

$12.99

VA 10-0415 Form

VA Geriatrics and Extended Care (GEC) Referral

$12.99

VA 10-0426 Form

Meds By Mail Order Form CHAMPVA

$12.99

VA 10-0430 Form

APPLICATION FOR ASSISTANCE FOR HIRING AND RETAINING NURSES AT STATE HOMES

$12.99

VA 10-0436 Form

Application for an Off-site Tissue Banking Waiver - Fillable

$12.99

VA 10-0445 Form

OCCUPATIONAL AND ENVIRONMENTAL EXPOSURE HISTORY

$12.99

VA 10-0455 Form

Clinical Trial Annual Progress Report

$12.99

VA 10-0455a Form

Clinical Trial Inclusion/Enrollment Report

$12.99

VA 10-0459 Form

Credentialing Release of Information Authorization

$12.99

VA 10-0460 Form

Request for Prescription Drugs from an Eligible Veteran in a State Home

$12.99

VA 10-0462 Form

Political Activities Fact Sheet and Certification

$12.99

VA 10-0474 Form

Application for Biospecimen Storage at a For-Profit Institution

$12.99

VA 10-0484 Form

Revocation for Release of Individually Identifiable Health Information

$12.99

VA 10-0490 Form

Acknowledgement of Receipt Of Department of Veterans Affairs Protected Health Information By Affiliated Educational Institutions

$12.99

VA 10-0502 Form

Ethics Consultation Feedback Tool

$12.99

VA 10-1010EZ Form

Application for Health Care Benefits VA 10-10EZ

$12.99

VA 10-1023 Form

Information Regarding Possible Claim Against Third Party fillable Stock #F01399

$12.99

VA 10-1086 Form

Research Consent Form

$12.99

VA 10-10d Form

Application for CHAMPVA Benefits- Fillable

$12.99

VA 10-10EC Form

Application For Extended Care Services

$12.99

VA 10-10EZ Form

Application for Health Benefits -fillable

$12.99

VA 10-10EZR Form

Health Benefits Renewal Form

$12.99

VA 10-10M Form

Medical Certificate

$12.99

VA 10-10SH Form

State Home Program Application for Veteran Care Medical Certificate-fillable

$12.99

VA 10-1170 Form

Application for Furnishing Nursing Home Care to Beneficiaries of VA- fillable

$12.99

VA 10-1223 Form

Report of Subcommittee on Human Studies

$12.99

VA 10-1245C Form

VA/Department of Defense Sharing Agreement

$12.99

VA 10-1313-1 Form

Merit Review Application

$12.99

VA 10-1313-10 Form

Research Advisory Group Summary Statement

$12.99

VA 10-1313-11 Form

Rehab Research & Dev. Svc-Scientific Merit Review Board Summary Statement

$12.99

VA 10-1313-13 Form

VHA Research & Development Letter of Intent Cover Page

$12.99

VA 10-1313-2 Form

Research and Development Program

$12.99

VA 10-1313-3 Form

Research & Development Program - Current Funds & First Year Request

$12.99

VA 10-1313-4 Form

Research & Development Program-Estimated

$12.99

VA 10-1313-5 Form

Research & Dev. Program-Investigator's Biographic Sketch

$12.99

VA 10-1313-6 Form

Research & Development Program - Investigator's Biography

$12.99

VA 10-1313-7 Form

VA Research & Development Program-Investigator's VA & Non-VA Research Support

$12.99

VA 10-1313-8 Form

Research & Dev. Program-Investigator's Total VA & Non-VA Research/Dev. Support

$12.99

VA 10-1313A Form

Merit Review Board Summary Sheet

$12.99

VA 10-1314 Form

HSR&D Carer Development Awardee Annual Progress Report

$12.99

VA 10-1394 Form

Application for Adaptive Equip - Motor Vehicle

$12.99

VA 10-1436 Form

Research and Development Information System Project Data Sheet

$12.99

VA 10-2065 Form

Funeral Arrangements - Fillable

$12.99

VA 10-2406 Form

Recommendation for Release of Patient in Home Other Than Patient's Own

$12.99

VA 10-2407 Form

Residential Care Home Program - Sponsor Application

$12.99

VA 10-2409 Form

Patient Agreement with Hospital in Relation to Home Other Than Own

$12.99

VA 10-2410 Form

Agreement to Provide Home Care to Patient

$12.99

VA 10-2478 Form

Veterans Request for Refill of Medication

$12.99

VA 10-2511 Form

Authority and Invoice for Travel by Ambulance or Other Hired Vehicle

$12.99

VA 10-2570D Form

Dental Record Authorization and Invoice for Outpatient Service - fillable

$12.99

VA 10-2649A Form

Interfacility Transfer Form

$12.99

VA 10-2649B Form

Physician Certification & Patient Consent for Transfer

$12.99

VA 10-2850 Form

Application for Physicians, Dentists, Podiatrists, Optometrists & Chiropractors

$12.99

VA 10-2850A Form

Application for Nurses and Nurse Anesthetists - Fillable -Order from SDC #F01045

$12.99

VA 10-2850B Form

Application for Residents

$12.99

VA 10-2850C Form

Application for Associated Health Occupations - Order from SDC #F05428

$12.99

VA 10-2850d Form

APPLICATION FOR HEALTH PROFESSIONS TRAINEES

$12.99

VA 10-3203 Form

Consent For Use of Picture and/or Voice

$12.99

VA 10-3567 Form

State Home Inspection

$12.99

VA 10-5345 Form

Request For and Authorization To Release Medical Records Fillable

$12.99

VA 10-5345a Form

Individuals' Request for a Copy of Their Own Health Information - fill

$12.99

VA 10-5345a-MHV Form

Individual's Rqst for Med Record from MyHealtheVet

$12.99

VA 10-5588 Form

State Home Report and Statement of Federal Aid Claimed

$12.99

VA 10-583 Form

Claim for Payment of Cost of Unauthorized Medical Services- Fillable

$12.99

VA 10-6001a Form

Contract Progress Report

$12.99

VA 10-6056A Form

Lease

$12.99

VA 10-6131 Form

Daily Log - Formal Contract

$12.99

VA 10-6298 Form

Architect - Engineer Fee Proposal

$12.99

VA 10-7055 Form

Application for Voluntary Service

$12.99

VA 10-7078 Form

Authorization and Invoice For Medical and Hospital Services- Fillable

$12.99

VA 10-7959A Form

CHAMPVA Claim Form

$12.99

VA 10-7959C Form

CHAMPVA - Other Health Insurance (OHI) Certificate

$12.99

VA 10-7959D Form

CHAMPVA Potential Liability Claim

$12.99

VA 10-7959E Form

Claim for Miscellaneous Expenses

$12.99

VA 10-7959f-1 Form

Foreign Medical Program (FMP) Registration Form - fill

$12.99

VA 10-7959f-2 Form

CLAIM COVER SHEET – FOREIGN MEDICAL PROGRAM (FMP) - fill

$12.99

VA 10-8678 Form

Application for Annual Clothing Allowance

$12.99

VA 10-9012 Form

Investigational Drug Information Record

$12.99

VA 20-572 Form

Request for Change of Address/Cancellation of Direct Deposit

$12.99

VA 20-8206 Form

VA Statement of Assurance of Compliance with Equal Opportunity Laws

$12.99

VA 20-8734 Form

Equal Opportunity Compliance Review Report

$12.99

VA 20-8734a Form

Supplement To Equal Opportunity Compliance Review Report

$12.99

VA 20-8800 Form

Request for VA Forms and Publications

$12.99

VA 21-0304 Form

Bene for Certain Children with Disab Born of Viet & Certain Korea Serv Vets (F)

$12.99

VA 21-0307 Form

Award Attachment for Certain Children with Disabilities Born of Vietnam Veterans

$12.99

VA 21-0501 Form

Veterans Benefits Timetable (No Fill-in)

$12.99

VA 21-0506 Form

Due Process Rights

$12.99

VA 21-0510 Form

Eligibility Verification Report Instructions (No Fill-in)

$12.99

VA 21-0512s-1 Form

Section 306 Eligibility Verification Report (Surviving Spouse)

$12.99

VA 21-0512V-1 Form

Old Law and Section 306 Eligibility Verification Report (Veteran)

$12.99

VA 21-0513-1 Form

Old Law and Section 306 Eligibility Verification Report

$12.99

VA 21-0514-1 Form

DIC Parent's Eligibility Verification Report

$12.99

VA 21-0516-1 Form

Improved Pension Eligibility Verification Report (Veteran W/ No Children)(Filla)

$12.99

VA 21-0517-1 Form

Improved Pension Eligibility Verification Report (Veteran with Children) 7 (Fil)

$12.99

VA 21-0518-1 Form

Improved Pension Eligibility Verif. Report -Surviving Spouse w/no Children (Fil)

$12.99

VA 21-0519c-1 Form

Improved Pension Eligibility Verification Report (Child or Children)

$12.99

VA 21-0519s-1 Form

Improved Pension Elig. Verifi. Report (Surviving Spouse w/Children)

$12.99

VA 21-0538 Form

Status of Dependents Questionnaire

$12.99

VA 21-0571 Form

Application For Exclusion Of Children's Income

$12.99

VA 21-0760 Form

VA Benefits in Brief (No Fill-in)

$12.99

VA 21-0779 Form

Req. for Nursing Home Info. in Connect. with Claim for Aid and Attendance

$12.99

VA 21-0781 Form

State. in Support of Claim for Serv. Connection for PTSD

$12.99

VA 21-0781a Form

State. in Suppt. of Claim for Serv. Conn. for PTSD Sec. to Pers. Trauma(Fillable

$12.99

VA 21-0784 Form

Supplemental Income Questionnaire (For Philippine Claims Only)

$12.99

VA 21-0788 Form

Information Regarding Apportionment of Beneficiary's Award

$12.99

VA 21-0789 Form

Your Rights to Representation and A Hearing (No Fill-in)

$12.99

VA 21-0790 Form

Your Rights to Representation and a Hearing (Possible Overpayment) (No Fill-in)

$12.99

VA 21-0819 Form

VA/DOD Joint Disability Evaluation Board Claim

$12.99

VA 21-0845 Form

Authorization To Disclose Personal Information To a Third Party

$12.99

VA 21-0847 Form

Request for Substitution of Claimant upon Death of Claimant

$12.99

VA 21-0960A-1 Form

Ischemic Heart Disease (IHD) Disability Benefits Questionnaire

$12.99

VA 21-0960B-1 Form

Hairy Cell and Other B-Cell Leukemias Disability Benefits Questionnaire

$12.99

VA 21-0960C-1 Form

Parkinson's Disease Disability Benefits Questionnaire

$12.99

VA 21-1775 Form

Statement of Disappearance

$12.99

VA 21-2008 Form

Application for United States Flag for Burial Purposes

$12.99

VA 21-22 Form

Appointment of Veterans Service Organization as Claimant's Rep.

$12.99

VA 21-22a Form

Appointment of Individual As Claimant's Representative

$12.99

VA 21-2680 Form

Exam. for Housebound Status or Permanent Need For Regular Aid and Attend.

$12.99

VA 21-4103 Form

Information From Remarried Widow/er

$12.99

VA 21-4138 Form

Statement in Support of Claim

$12.99

VA 21-4138(CF) Form

Statement in Support of Claim (Filipino Veterans Equity Compensation Fund)

$12.99

VA 21-4140-1 Form

Employment Questionnaire

$12.99

VA 21-4142 Form

Authorization and Consent to Release Information to the Dept. of VA

$12.99

VA 21-4165 Form

Pension Claim Questionnaire for Farm Income

$12.99

VA 21-4170 Form

Statement of Marital Relationship

$12.99

VA 21-4171 Form

Supporting Statement Regarding Marriage

$12.99

VA 21-4176 Form

Report of Accidental Injury in Support of Claim for Compensation or Pension (F)

$12.99

VA 21-4185 Form

Report of Income from Property or Business

$12.99

VA 21-4192 Form

Request for Employment Info in Connection with Claim for Disability Benefits (F)

$12.99

VA 21-4502 Form

Application for Auto or Other Conveyance and Adaptive Equipment

$12.99

VA 21-4706b Form

Federal Fiduciary's Account

$12.99

VA 21-4706c Form

Court Appointed Fiduciary's Account

$12.99

VA 21-4709 Form

Certificate as to Assets

$12.99

VA 21-4718a Form

Certificate of Bal. on Deposit and Auth. to Disclose Financial Record

$12.99

VA 21-509 Form

Statement of Dependency of Parent(s)

$12.99

VA 21-524 Form

Statement of Person Claiming to Have Stood in Relation of Parent

$12.99

VA 21-526 Form

Veteran's Application for Compensation and/or Pension

$59.00

VA 21-526b Form

Veteran's Supplemental Claim for Compensation

$40

VA 21-526c Form

Pre-Discharge Compensation Claim

$12.99

VA 21-526EZ Form

FULLY DEVELOPED CLAIM (Compensation)

$12.99

VA 21-527 Form

Income-Net Worth and Employment Statement

$12.99

VA 21-527EZ Form

FULL DEVELOPED CLAIM (Pension)

$12.99

VA 21-530 Form

Application for Burial Benefits

$12.99

VA 21-530a Form

State Application for Interment Allowance under 38 USC Chapter 23

$12.99

VA 21-534 Form

Appl. for DIC, Death Pension & Accrued Benefits by Surviving Spouse or Child (F)

$12.99

VA 21-534a Form

Appli. for DIC by a Surviving Spouse or Child - In-Service Death Only

$12.99

VA 21-535 Form

Application for Dependency and Indemnity Compensation by Parent(s)

$12.99

VA 21-601 Form

Application for Accrued Amounts Due A Deceased Beneficiary

$12.99

VA 21-651 Form

Election of Comppensation in Lieu of Retired Pay or Waiver of Retired Pay to Secure Compensation from Department of Veterans Affairs

$12.99

VA 21-674 Form

Request for Approval of School Attendance

$12.99

VA 21-674b Form

School Attendance Report

$12.99

VA 21-686c Form

Declaration of Status of Dependents

$12.99

VA 21-6898 Form

Application for Amounts on Deposit for Deceased Veteran

$12.99

VA 21-8049 Form

Request for Details of Expenses

$12.99

VA 21-8416 Form

Medical Expense Report

$12.99

VA 21-8416b Form

Report of Medical, Legal & Other Expenses Incident to Recov. for Injury or Death

$12.99

VA 21-8764 Form

Disability Compensation Award Attachment Important Information (F)

$12.99

VA 21-8764a Form

Disability Compensation Award Under 38 U.S.C. 1151 Important Information (F)

$12.99

VA 21-8767 Form

Death Pension Award Attachment (F)

$12.99

VA 21-8768 Form

Disability Pension Award Attachment

$12.99

VA 21-8834 Form

Application for Reimbursement of Headstone or Marker Expense

$12.99

VA 21-8924 Form

Application of Surviving Spouse or Child for REPS Benefits

$12.99

VA 21-8940 Form

Veteran's Application for Increased Compensation Based on Unemployability

$12.99

VA 21-8941 Form

REPS Annual Eligibility Report

$12.99

VA 21-8951-2 Form

Notice of Waiver of VA Comp or Pension to Receive Military Pay and Allowances

$12.99

VA 22-0803 Form

Application for Reimbursement of Licensing or Certification Test Fees

$12.99

VA 22-0810 Form

Application for Reimbursement of National Exam Fee

$12.99

VA 22-0830 Form

Agreement for Release of VA Education Information to Third Party

$12.99

VA 22-0839 Form

Yellow Ribbon Program Agreement (Under chapter 33 of title 38, U.S.C.)

$12.99

VA 22-0848 Form

Application for Rural Relocation Benefit under the Post 9/11 GI Bill

$12.99

VA 22-1990 Form

Application for VA Education Benefits

$12.99

VA 22-1990e Form

Application for Family Member to use Transferred Benefits

$12.99

VA 22-1990n Form

Application for VA Education Benefits Under the National Call to Service Program (FiIlable)

$12.99

VA 22-1995 Form

Request for Change of Program or Place of Training

$12.99

VA 22-1999c Form

Certificate of Affirmation of Enrollment Agreement Correspondence Course

$12.99

VA 22-5281 Form

Application for Refund of Educational Contributions (VEAP, Ch. 32, Title 38, U.S.C.)

$12.99

VA 22-5490 Form

Dependents' Application for VA Education Benefits

$12.99

VA 22-5495 Form

Dependents' Request for Change of Program or Place of Training

$12.99

VA 22-8597 Form

Fact Sheet on Approval of OJT Programs (F)

$12.99

VA 22-8691 Form

Application for Work-Study Allowance

$12.99

VA 22-8692 Form

Student Work-Study Agreement (Advance Payment)

$12.99

VA 22-8692a Form

Extended Student Work-Study Agreement

$12.99

VA 22-8692b Form

Student Work-Study Agreement

$12.99

VA 22-8864 Form

Other On-The-Job Training and Apprenticeship Training Agreement and Standards

$12.99

VA 22-8873 Form

Supp Info for Chg of Prog or Reenroll After Unsat Attend, Condt or Progress (F)

$12.99

VA 22-8889 Form

Application for Educational Assistance Test Program Benefits

$12.99

VA 24-0296 Form

Direct Deposit Enrollment

$12.99

VA 24-0296a Form

Direct Deposit Enrollment - Australia

$12.99

VA 24-0296b Form

Direct Deposit Enrollment - Canada

$12.99

VA 24-0296c Form

EFT Enrollment - Germany

$12.99

VA 24-0296d Form

EFT Enrollment - Ireland

$12.99

VA 24-0296e Form

EFT Enrollment - United Kingdom

$12.99

VA 26-0285 Form

VA Transmittal List - Discontinued

$12.99

VA 26-0286 Form

VA Loan Summary Sheet

$12.99

VA 26-0302 Form

Notice of Special Flood Hazards and Availability of Federal Disaster Relief Assistance

$12.99

VA 26-0503 Form

Federal Collection Policy Notice

$12.99

VA 26-0551 Form

Debt Questionnaire

$12.99

VA 26-0592 Form

Counseling Checklist for Military Homebuyers

$12.99