Residency Verification Report-Veterans and Survivors (Form Letter 21-914)

OMB 2900-0655

Form Letter 21-914 gathers the information necessary to verify that a Filipino veteran or beneficiary who is receiving benefits at the full-dollar rate based on U.S. residency continues to meet the residency requirements. The proper rate of payment could not be determined without this information.

The latest form for Residency Verification Report-Veterans and Survivors (Form Letter 21-914) expires 2024-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form VA FL 21-914 Residency Verification Report-Veterans and Survivors (FL21-914) Form
2023-26548, 30-Day FRN (2900-0655).pdf Supplementary Document
2023-21522, 60-Day FRN (2900-0655).pdf Supplementary Document
2900-0655, Supporting Statement (FL21-914).docx Supporting Statement A
Residency Verification Report-Veterans and Survivors (FL21-914) Form

202309-2900-008 Approved without change	Revision of a currently approved collection	2023-12-06
202006-2900-005	Reinstatement without change of a previously approved collection	2020-12-17
201610-2900-004 Approved without change	Extension without change of a currently approved collection	2017-03-30
201307-2900-017 Approved with change	Revision of a currently approved collection	2014-03-24
201010-2900-001 Approved without change	Extension without change of a currently approved collection	2011-01-03
200712-2900-013 Approved without change	Extension without change of a currently approved collection	2007-12-17
200410-2900-004 Approved without change	New collection (Request for a new OMB Control Number)	2004-10-22