OMB control number
Statement of Dependency of Parent(s) (VA Form 21-509)
OMB 2900-0089 ยท VA.
OMB 2900-0089
VA Form 21-509 is the prescribed form used by VBA to gather income and dependency information from claimants who are seeking payment of benefits as, or for dependent parent(s). VA Form 21-509 is used by a Veteran seeking to establish their parent(s) as dependent(s) and by a surviving parent seeking death compensation. This information is used to determine the dependency of the parent and make determinations which affect the payment of monetary benefits to the claimant. Without this information, determination of entitlement would not be possible.
The latest form for Statement of Dependency of Parent(s) (VA Form 21-509) expires 2027-05-31 and is listed under ICR 202402-2900-005.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 21-509 Statement of Dependency of Parent(s) (VA Form 21-509) | Form |
| 30-Day FRN - 2900-0089 (2024).pdf | Supplementary Document |
 2024-02739, 60-Day FRN (VAF21-509).pdf | Supplementary Document |
| 2900-0089, Supporting Statement (VAF21-509).docx | Supporting Statement A |
 Statement of Dependency of Parent(s) (VA Form 21-509) |
Form |