Updated VA Form 10-10EZR (2022)

VA Health Benefits: Application, Update, Hardship Determination - VA Forms 10-10EZ,10-10EZR and 10-10HS

OMB: 2900-0091

IC ID: 256200

Documents and Forms

Document Name Document Type
Form 10-10EZR Updated VA Form 10-10EZR (2022) Form and Instruction
Form 10-10EZR Updated VA Form 10-10EZR (2022) Form and Instruction
10-10EZR Health Benefits Update Form VA Form 10-10EZR_updated 2022.pdf Form and Instruction
10-10EZR - revised Health Benefits Update Form VA Form 10-10EZR_PACT Act - Sec 103 revisions_JAN 2024_v3.pdf Form and Instruction