OMB control number
Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966)
OMB 2900-0826 ยท VA.
OMB 2900-0826
VA Form 21-0966 is used to gather the necessary information to determine an effective date for an award granted in association with a complete claim filed within one year of such form. VA also uses it as a request for application and responds by mailing the claimant a letter of receipt, along with the appropriate VA form or application for VA benefits. Without this information, determination of entitlement would not be possible.
The latest form for Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) expires 2029-05-31 and is listed under ICR 202512-2900-007.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 21-0966 Intent to File a Claim for Compensation and/or Pension or Survivors Pension and/or DIC | Form |
 Comment-Response1, VAF21-0966 (2900-0826).docx | Public Comments |
| Comment-Response2, VAF21-0966 (2900-0826) (1).docx | Public Comments |
| 30-Day FRN (published) 2900-0826.pdf (document unavailable) | Supplementary Document |
| VA-2025-VACO-0001-0137 2900-0826 2.pdf | Public Comments |
| VA-2025-VACO-0001-0151 2900-0826 1.pdf (document unavailable) | Public Comments |
| 60-Day FRN (published) 2900-0826.pdf | Supplementary Document |
| 2900-0826, Supporting Statement (VAF21-0966) 1.docx | Supporting Statement A |
 Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) |
Form |
| Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202512-2900-007 | Revision of a currently approved collection | 2026-02-26 | ||
| 202111-2900-007 | Reinstatement with change of a previously approved collection | 2023-01-17 | Approved without change | |
| 201801-2900-004 | Extension without change of a currently approved collection | 2018-06-21 | Approved without change | |
| 201501-2900-006 | Revision of a currently approved collection | 2015-05-22 | Approved without change | |
| 201407-2900-019 | New collection (Request for a new OMB Control Number) | 2014-07-30 | Approved with change |