Form 21 0820 – Fill Out and Use This PDF

Form 21 0820 is a form that you fill out when applying for an Ontario driver's license. The form requires you to submit your social insurance number, proof of address, and pay the fee of $50.

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Form 21 0820 PDF Details

Form 21 0820 is a form used by taxpayers to request abatement, refund, or credit of amount of estimated tax paid. The form can be used to request a refund for overpayment of estimated tax or to request that the estimated tax payment(s) be applied to the current year's tax liability. This form should be completed and submitted if you would like any money back from the IRS related to your estimated taxes. Remember, though, that refunds are only given if too much was paid in estimate taxes - so it's best to overestimate than underestimate! More information about Form 21 0820 can be found on the official IRS website.

The table contains details about the form 21 0820. This site will give you details about the form's size, completion time, and the blanks you are expected to fill.

Question	Answer
Form Name	Form 21 0820
Form Length	1 pages
Fillable?	Yes
Fillable fields	51
Avg. time to fill out	10 min 27 sec
Other names	va form 21 0820, 21 0820, veterans affairs form 21 0820, va form 0820 pdf

12

Form Preview 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)
	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

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