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

VBA administers an integrated program of of benefits and services established by law for Veterans, service personnel, and their dependents, survivors, and/or beneficiaries. A claimant’s eligibility for pension benefits or Parents’ Dependency and Indemnity Compensation (DIC) is determined, in part, by countable income. VA Form 21P-4171 is primarily used to collect information from third-parties regarding claimed common-law marriage between Veterans and spouses/surviving spouses. VBA uses the information collected to determine whether the claimed common-law marriage is valid under the law of the place where the parties resided at the time of marriage, or the law of the place where the parties resided when the right to benefits accrued, to comply with 38 CFR §3.1(j) and pay monetary benefits.

The latest form for Supporting Statement Regarding Marriage (VA Form 21P-4171) expires 2027-05-31 and is listed under ICR 202401-2900-010.