Supporting Statement Regarding Marriage (VA Form 21P-4171)

OMB 2900-0115

OMB 2900-0115

VA Form 21P-4171 is used to gather information that is needed to determine veteran's spouses' eligibility for benefits based on a common law marital relationship.

The latest form for Supporting Statement Regarding Marriage (VA Form 21P-4171) expires 2021-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material
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Name
Form
Supplementary Document
Supporting Statement A
Supplementary Document
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 Revision of a currently approved collection 2024-04-15
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 Reinstatement without change of a previously approved collection 2021-05-03
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Approved without change
 Revision of a currently approved collection 2014-06-02
Approved without change
 Extension without change of a currently approved collection 2011-06-24
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 Extension without change of a currently approved collection 2008-04-03
Approved with change
 Revision of a currently approved collection 2005-06-14
Approved with change
 Revision of a currently approved collection 2002-05-15
Approved without change
 Reinstatement without change of a previously approved collection 1999-04-12
Approved without change
 Extension without change of a currently approved collection 1995-08-23
Approved without change
 Extension without change of a currently approved collection 1992-08-27
Approved without change
 Reinstatement with change of a previously approved collection 1990-03-23
Approved without change
 Extension without change of a currently approved collection 1984-06-19
Approved without change
 Extension without change of a currently approved collection 1981-04-17
Approved with change
 No material or nonsubstantive change to a currently approved collection 1981-01-22
Approved without change
 Revision of a currently approved collection 1976-06-29
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