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.

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