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The VA Form 21-0820 serves as an important tool for veterans and their dependents to provide and report general information to the Department of Veterans Affairs (VA). This form, commonly referred to as the Report of General Information, seeks to collect essential details to ensure accurate record-keeping and eligibility determinations for VA benefits. Information recorded on this form becomes a permanent part of the veteran's file, requiring respondents to complete it either in ink or using a typewriter or computer. Key sections include the veteran's identification numbers, personal contact details, and specifics about the interaction, such as the date of contact and the nature of the communication. Respondents must also indicate if they are the veteran or another authorized individual, while providing a brief statement of the information exchanged. Adherence to privacy regulations is crucial, and the form includes a privacy notice explaining how the information collected may be used or disclosed. With an estimated completion time of just five minutes, the VA Form 21-0820 is designed to streamline vital interactions between veterans and the VA, facilitating timely processing of claims and requests for benefits.

21 0820 Example

 

 

 

OMB Approved No. 2900-XXXX

 

 

 

Respondent Burden: 5 minutes

 

 

 

 

REPORT OF GENERAL INFORMATION

 

 

 

 

NOTE - This form must be filled out in ink or on a typewriter/computer,

 

1. VA OFFICE

2. IDENTIFICATION NUMBERS (C, XC, SS, XSS, V, K, etc.)

as it becomes a permanent record in the veteran's folder.

 

 

 

 

 

 

 

3. LAST NAME - FIRST NAME - MIDDLE NAME OF VETERAN (Type or print)

 

 

4. DATE OF CONTACT (Month, day, year)

5. ADDRESS OF VETERAN (Include number and street or rural route, city or P.O., State and ZIP Code)

6A. TELEPHONE NUMBER OF VETERAN (Include Area Code)

 

 

 

 

 

 

DAY

 

EVENING

 

(

)

(

)

 

 

 

 

 

6B. E-MAIL ADDRESS (If applicable)

 

7. PERSON CONTACTED

8. ADDRESS OF PERSON CONTACTED

9. TYPE OF CONTACT (Check)

PERSONAL TELEPHONE

10.TELEPHONE NUMBER OF PERSON CONTACTED (Include Area Code)

( )

I identified myself as a VA employee who is authorized to receive information (38 CFR 3.217)

I verified the identity of the caller as being the veteran/beneficiary/claimant/fiduciary by obtaining the following (place an "X" or check mark next to each applicable item)

Check

THE VETERAN

Check

THE BENEFICIARY

Check

ANOTHER CLAIMANT

(

 

)

 

(

 

)

(i.e., DIC, Death Pension, Ch. 35, or

(

 

)

 

 

 

 

Apportionment)

 

 

 

 

 

 

Claim Number or SSN

 

 

 

Veteran's Claim Number or SSN

 

 

 

Veteran's Claim Number or SSN

 

 

 

 

Full Name

 

 

 

Veteran's Full Name

 

 

 

Veteran's Full Name

 

 

 

 

Branch of Service

 

 

 

Veteran's Branch of Service

 

 

 

Veteran's Branch of Service

 

 

 

 

Entry OR Release Service Dates

 

 

 

Beneficiary's Full Name

 

 

 

Claimant's Full Name

 

 

 

 

(mm/yyyy__________________________)

 

 

 

Beneficiary's SSN

 

 

 

Claimant's Address

 

 

 

For change of address/direct deposit, you

 

 

For change of address/direct deposit, you

 

 

 

 

 

 

 

 

must also ask the following:

 

 

 

must also ask the following:

 

 

 

 

 

 

 

 

Address of Record

 

 

 

Address of Record

 

 

 

 

 

 

 

 

Type of Benefit (Claimed or in receipt of)

 

 

 

Type of Benefit (Claimed or in receipt of)

 

 

 

 

 

 

 

 

Current Check Amount

 

 

 

Current Check Amount

 

 

 

 

If dependents are of record:

If dependents are of record:

 

 

 

 

 

 

 

 

Name and SSN or Spouse OR

 

 

 

Name and SSN or Spouse OR

 

 

 

 

 

 

 

 

Name and birthday of one child

 

 

 

Name and birthday of one child

 

 

 

 

BRIEF STATEMENT OF INFORMATION REQUESTED AND GIVEN:

Notification of Action

I read the following summary of the Privacy Act statement to the caller:

"I am a VA employee who is authorized to receive or request evidentiary information or statements that may result in a change in your VA benefits. The primary purpose for gathering this information or statement is to make an eligibility determination. It is subject to verification through computer matching programs with other agencies."

I informed caller we will issue a notification letter incorporating this information.

I informed caller that information provided would be used to calculate benefit amounts that may result in a reduction or termination.

I informed caller that any potential overpayment could be reduced by immediate action.

I confirmed the caller understood and that he or she elected immediate action to minimize a potential debt.

ccto POA (If applicable):

DIVISION OR SECTION

EXECUTED BY (Signature and title)

 

 

PRIVACY ACT NOTICE: The VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 5, Code of Federal Regulations 1.576 for routine uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA benefits, verification of identity and status, and personnel administration) as identified in the VA system of records, 58VA/21/22/28 Compensation, Pension, Education and Vocational Rehabilitation Records - VA, and published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. The responses you submit are considered confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching programs with other agencies.

RESPONDENT BURDEN: We need this information to obtain evidence in support of your claim for benefits (38 U.S.C. 501(a) and (b)). Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 5 minutes to respond to the questions on this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.whitehouse.gov/omb/OMBINV.VA.EPA.html#VA. If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.

VA FORM

21-0820

NOV 2008

Form Characteristics

Fact Description
OMB Approval This form is approved by the Office of Management and Budget (OMB) under approval number 2900-XXXX.
Purpose Form 21-0820 serves to report general information relevant to veterans and their claims.
Filling Instructions The form must be completed in ink or using a typewriter/computer to ensure clarity and permanence in records.
Respondent Burden Completing this form is estimated to take about 5 minutes of the respondent's time.
Privacy Act Notice Information collected on this form is protected and will not be disclosed beyond authorized uses as per the Privacy Act of 1974.

Guidelines on Utilizing 21 0820

After gathering the necessary information, the form must be completed meticulously to ensure accuracy. Incomplete or incorrect information may delay the processing of the claim. The following steps outline the process for filling out the 21-0820 form properly.

  1. Use ink or type the form on a computer or typewriter as it will become a permanent record in the veteran's file.
  2. In the VA OFFICE field, enter the designated VA office handling the case.
  3. Fill in the IDENTIFICATION NUMBERS section, ensuring to include any relevant codes such as C, XC, SS, XSS, V, K, etc.
  4. Provide the LAST NAME, FIRST NAME, and MIDDLE NAME of the veteran. Use clear printing or typing.
  5. Enter the DATE OF CONTACT in the format of month, day, year.
  6. In the ADDRESS OF VETERAN field, include the complete address: number and street or rural route, city or P.O., state, and ZIP code.
  7. Input the TELEPHONE NUMBER OF VETERAN for both day and evening, including the area code.
  8. If applicable, provide the E-MAIL ADDRESS of the veteran.
  9. Identify the PERSON CONTACTED and enter their details.
  10. Complete the ADDRESS OF PERSON CONTACTED section.
  11. Check the TYPE OF CONTACT by marking the appropriate box: PERSONAL or TELEPHONE.
  12. Fill in the TELEPHONE NUMBER OF PERSON CONTACTED, including the area code.
  13. Indicate your identification as a VA employee and verify the identity of the caller by checking the relevant items (veteran, beneficiary, another claimant) and supplying the necessary details for each applicable option.
  14. For changes involving address or direct deposit, make sure to ask the designated questions listed on the form.
  15. Summarize the BRIEF STATEMENT OF INFORMATION REQUESTED AND GIVEN clearly and concisely.
  16. Document the notification of action provided to the caller, ensuring to include the key points about the Privacy Act statement.
  17. If applicable, add the ccto POA (Power of Attorney) information.
  18. Sign and date the form under the DIVISION OR SECTION EXECUTED BY area.

Check the completed form for accuracy before submission, as this ensures a smoother process for your claim. Be prepared to send the form to the appropriate office as directed in your instructions, following any additional guidance that may apply to your specific situation.

What You Should Know About This Form

What is the purpose of the VA Form 21-0820?

The VA Form 21-0820, also known as the Report of General Information, is designed to collect vital information related to a veteran's benefits. It serves as a record for interactions between the VA and veterans or their representatives. This form helps ensure proper documentation is maintained in a veteran's folder, which can affect eligibility for benefits and other important matters.

How should I complete the VA Form 21-0820?

The form must be filled out using either ink or typing on a computer. It is essential to provide accurate and complete information, including personal details like the veteran's full name, address, and contact numbers. You should also identify the purpose of the contact and provide details about the person contacted, if applicable. Every field is important, so ensure all necessary information is included for the form to be processed correctly.

How long does it take to fill out the VA Form 21-0820?

On average, completing the VA Form 21-0820 should take about 5 minutes. This timeframe allows you enough opportunity to gather the required information and fill out the form accurately. However, be sure to allocate additional time in case you need to refer to records or clarify any details before submission.

What happens to the information I provide on the form?

The information collected through the VA Form 21-0820 is confidential and will only be used for authorized purposes under the Privacy Act of 1974. It is primarily used to determine eligibility for VA benefits and may involve verification with other agencies. Once submitted, the information is stored in the veteran's records and could impact future benefit calculations.

Where can I send my completed VA Form 21-0820?

Upon completing the VA Form 21-0820, you should send it to the designated VA office handling your claim or benefits. If you are unsure where to send the form, you can contact the VA at 1-800-827-1000 for guidance. It is crucial to ensure it reaches the correct office to facilitate timely processing of your information.

Common mistakes

When completing the VA Form 21-0820, it's important to be aware of common mistakes that can delay processing. One frequent error is not filling out the form using ink or a typewriter. The form is intended to become a permanent record in the veteran’s folder, and a printed format is essential for clarity.

Another common oversight involves incorrect identification numbers. Veterans may either leave this section blank or provide inaccurate details, which can hinder proper identification. Ensuring that all numbers, such as the Claim Number or SSN, are entered correctly is crucial.

Providing incomplete names can also lead to issues. Many individuals forget to include their middle name or may list their name in the wrong order. It's necessary to carefully print or type the complete last name, first name, and middle name as required in sections three.

Additionally, errors in the veteran’s contact date are common. Veterans must enter the correct date of contact in the specified format (month, day, year), and overlooking this can result in a form being returned for correction.

Address details should be accurate and complete. It’s essential to include the full address, including street number, city, state, and ZIP code. Omitting any part of the address can lead to difficulties in communication and processing.

Furthermore, many neglect to include their telephone number and, if applicable, email address. Sections 6A and 6B are crucial for follow-up, yet they are often left blank, complicating further communication.

Another mistake is failing to clearly identify the person contacted. It’s important to fill out section 7 accurately. If the individual filling out the form fails to indicate their relationship to the veteran, it might confuse the VA staff reviewing the document.

When indicating the type of contact, individuals sometimes forget to check the appropriate box. Selecting whether the contact was personal or by telephone is key for record-keeping and clarification.

In the verification section, some submitters do not provide sufficient verification details. It’s important to check each applicable item accurately and ensure that all requested information regarding identity is recorded.

Lastly, a lack of attention to the brief statement of information requested can lead to incomplete submissions. Providing a clear and concise explanation in this section is vital for the VA to understand the context of the request. Taking care to address these common mistakes can streamline the processing of the form and help veterans receive the benefits they deserve.

Documents used along the form

The VA Form 21-0820 is commonly used to report general information regarding veterans and benefits. However, several other forms and documents frequently accompany it to ensure comprehensive processing of veteran claims. Below is a list of these documents, along with brief descriptions of their purposes.

  • VA Form 21-526EZ: This form is used to apply for disability compensation or pension benefits. Veterans submit this document to initiate their claims for various forms of financial support from the VA.
  • VA Form 21-4138: Known as the Statement in Support of Claim, this form allows claimants to provide additional information, including personal statements or documentation that may help in support of their benefits claims.
  • VA Form 21-674: This document is used to apply for educational assistance for dependents of veterans. It helps secure benefits for family members who may need assistance for pursuing educational opportunities.
  • VA Form 21-0966: The Intent to File a Claim form indicates a veteran’s intention to file a claim for disability benefits. This form allows individuals to establish a potential effective date for those benefits while they prepare their full claims.

Utilizing these forms in conjunction with the VA Form 21-0820 helps streamline the claims process, ensuring that veterans receive the necessary support in a timely manner. Proper completion and submission of these documents can significantly affect benefit eligibility and the speed of approvals.

Similar forms

The VA Form 21-0820, a report of general information, shares similarities with several other forms used by the Department of Veterans Affairs and other related agencies. Each document serves a specific purpose but often contains overlapping fields and intended uses. Here are five forms that resemble the 21-0820 form, along with explanations of how they are alike:

  • VA Form 21-526EZ: This is an application for disability compensation and related compensation benefits. Like the 21-0820, it requires personal information of the veteran and includes sections on benefits and identification, ensuring accurate record-keeping.
  • VA Form 21-534EZ: The application for Dependency and Indemnity Compensation (DIC) and Death Pension benefits is closely related to the 21-0820. Both require detailed personal identification and verification of claims for benefits, specifically tailored to the needs of veterans and their beneficiaries.
  • VA Form 21-527EZ: This form is used for pension benefits. Similar to the 21-0820, it includes sections for personal identification, contact information, and inquiries related to the veteran's financial status, which helps in determining eligibility for specific programs.
  • VA Form 21-0958: Known as a Notice of Disagreement, this form is used to appeal a decision made by the VA. The connection lies in the need for identification information, as both documents gather essential details to support claims and facilitate communication regarding benefits.
  • VA Form 21-4138: This is a statement in support of a claim. Consistent with the 21-0820, it gathers information regarding the veteran or claimant and can support ongoing claims with critical details about circumstances and evidence, showcasing the importance of accurate documentation in the VA process.

Each of these forms interacts with the overarching goals of the VA, which include ensuring that veterans receive the benefits they are entitled to while maintaining accurate records and communication pathways. While their specific purposes may differ, the emphasis on personal and benefit-related information remains a common thread among them.

Dos and Don'ts

When filling out the VA Form 21-0820, there are several important steps to follow for a smooth process. Here are five things you should and shouldn't do:

  • Always use ink or a typewriter/computer as the form needs to be legible and becomes part of the permanent record.
  • Ensure all identification numbers, such as the Veteran's Claim Number or Social Security Number, are provided accurately.
  • Include the correct contact information for both the veteran and the person contacted to help identify them easily.
  • Read and understand the Privacy Act statement before sharing any information to know how it will be used.
  • Make sure to sign and date the form after completion to validate your submission.
  • Do not leave any required fields blank; incomplete forms may delay processing.
  • Avoid using pencil, as this can lead to smudging and illegibility over time.
  • Do not submit forms without ensuring that all necessary information has been communicated clearly.
  • Refrain from providing unnecessary personal information that is not requested on the form.
  • Never hesitate to seek assistance if you are unsure about filling out any section; it’s better to ask than to guess.

Misconceptions

  • Misunderstanding the Purpose: Many people think that the 21-0820 form is used for applying for benefits. In reality, it’s designed to report general information that may affect a veteran’s benefits.
  • Assuming It's Optional: Some believe that completing the form is optional. However, it is required for certain processes to be carried out, making it important for maintaining eligibility.
  • Not Realizing It's a Permanent Record: There's a misconception that information provided may not be stored. In fact, the details entered become a permanent part of the veteran’s record.
  • Believing It's Only for Veterans: A common myth is that only veterans can fill out the form. The form can also be used by beneficiaries or certain designated representatives.
  • Ignoring the Time Requirement: Many assume it takes a long time to fill out the form. The estimated completion time is about five minutes, making it a quick process.
  • Underestimating Privacy Concerns: Some people think their information is not protected. The form includes a Privacy Act notice, ensuring that information is kept confidential and used only as permitted.
  • Confusing It with Other Forms: People may mistakenly believe the 21-0820 form serves the same purpose as other VA forms. Each form has a specific function; knowing which form to use is crucial.
  • Thinking It's for Emergency Use: The form is not intended for emergency situations like urgent benefit requests. It is used for reporting information or changes that may impact benefits over time.
  • Assuming that Online Submission is Not Allowed: There's a belief that the form must be mailed. However, it can be completed electronically, making submission easier for veterans and beneficiaries.
  • Believing There Are No Consequences for Not Filing: Some feel that skipping submission will have no impact. Omitting this form might delay benefit processing or impact eligibility.

Key takeaways

When filling out and using the 21-0820 form, a few important aspects should be kept in mind to ensure accuracy and compliance.

  • Proper Completion: The form must be filled out in ink, or you can opt to use a typewriter or computer. It's crucial to provide all the necessary details accurately to avoid any processing delays.
  • Confidential Information: Remember that the information you submit is confidential. It will only be disclosed as permitted under the Privacy Act of 1974, so take care when sharing personal details.
  • Eligible Contacts: Identify who you are contacting and ensure that you collect all required verification information. This includes checking the veteran’s name, claim numbers, and service details before proceeding.
  • Respondent Burden: The estimated time to complete the form is about five minutes. Be mindful that while this may seem quick, providing comprehensive and accurate answers is essential for your claim's support.