Va Form 21 0518 1 PDF Details

The VA 21 0518 1 form is a critical document for surviving spouses of veterans, aimed at establishing or verifying eligibility for improved pension benefits. As indicated by the OMB Control No. 2900-0101, this form requests comprehensive information, including personal details such as the Social Security numbers of both the surviving spouse and the veteran, along with the surviving spouse's marital status and details regarding any dependent children. Furthermore, it addresses situations like residency in nursing homes, employment status over the past year, other VA benefits potentially received, and detailed income and net worth reporting. The necessity to report any changes in income during the past 12 months highlights the form's role in ensuring accurate financial assessments for pension eligibility. Moreover, the inclusion of educational, vocational rehabilitation, and medical expenses underlines the holistic approach to assessing the needs of surviving spouses. The seriousness of the process is underscored by the penalty warning for submitting false statements or evidence. With an estimated completion time of 30 minutes and an expiration date of June 30, 2021, it is designed to be thorough yet user-friendly, incorporating instructions via VA Form 21P-0510 to guide applicants through the process smoothly.

QuestionAnswer
Form NameVa Form 21 0518 1
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesva form 21 0518 1, va form 21 8951 fillable form, improved va, va form 0518

Form Preview Example

 

OMB Control No. 2900-0101

 

Respondent Burden: 30 minutes

 

Expiration Date: 06/30/2021

FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN

 

 

 

 

 

 

 

FIRST NAME - MIDDLE NAME - LAST NAME OF SURVIVING SPOUSE

IMPROVED PENSION ELIGIBILITY

 

VERIFICATION REPORT

 

(SURVIVING SPOUSE WITH NO CHILDREN) 8

 

 

 

COMPLETE MAILING ADDRESS OF SURVIVING SPOUSE

VA FILE NUMBER

 

 

 

 

VA REGIONAL OFFICE RETURN ADDRESS

 

 

 

 

IMPORTANT - Please read the enclosed EVR Instructions (VA Form 21P-0510) prior to completing this form.

1A. YOUR SOCIAL SECURITY NUMBER

1B. VETERAN'S SOCIAL SECURITY NUMBER

1C. YOUR DATE OF BIRTH (Mo., day, yr.)

2.YOUR MARITAL STATUS (Check only one box)

(1) I HAVE NOT REMARRIED SINCE THE VETERAN DIED (You have not married anyone since the veteran's death.)

(2)

 

I REMARRIED ON

 

(Date) AND I AM STILL MARRIED (You married after the veteran's death and you are currently

 

 

 

 

 

 

 

married. Enter the date you married your current spouse.)

(3)

 

I REMARRIED AFTER THE VETERAN DIED BUT THE MARRIAGE ENDED BY DEATH OR DIVORCE ON

.

 

 

(You remarried but you are not currently married. Show the date your latest marriage ended.)

 

 

 

 

 

 

3. NUMBER OF UNMARRIED, DEPENDENT CHILDREN (See Paragraph 1 of the EVR Instructions)

IN YOUR CUSTODY

 

NOT IN YOUR CUSTODY

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT CONTRIBUTED DURING PAST 12 MONTHS TO CHILDREN NOT IN YOUR CUSTODY $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4A. ARE YOU A PATIENT IN A NURSING HOME?

4C. ENTER THE NAME, COMPLETE ADDRESS, AND

 

 

 

 

 

 

 

 

 

TELEPHONE NUMBER OF NURSING HOME

 

 

YES

 

NO (If "Yes", Complete Items 4B thru 4D. If "No", go to Item 5.)

(Please include Zip Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4B. SHOW THE DATE YOU ENTERED THE NURSING HOME

 

 

 

4D. DOES MEDICAID COVER ALL OR PART OF YOUR NURSING HOME FEES?

YES NO

5.DID YOU RECEIVE ANY WAGES OR WERE YOU EMPLOYED AT ANY TIME DURING THE PAST 12 MONTHS?

 

 

YES

 

NO

 

 

 

 

 

6. DO YOU RECEIVE ANY OTHER VA BENEFITS AS A VETERAN, PARENT, OR SURVIVING SPOUSE?

 

 

YES

 

 

NO

(If "Yes", write in the VA file number of the other benefit.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA FORM

21P-0518-1

SUPERSEDES VA FORM 21-0518-1, APR 2015,

PAGE 1

JUN 2018

WHICH WILL NOT BE USED.

 

7A. MONTHLY INCOME (Read Paragraphs 2 and 3 of the EVR Instructions)

If no income or net worth was received from a particular source, write "0" or "none". VA WILL INTERPRET A BLANK SPACE AS "NONE" OR "0."

SOURCE

SURVIVING SPOUSE

SOCIAL SECURITY

$

 

 

 

U.S. CIVIL SERVICE

 

 

 

U.S. RAILROAD RETIREMENT

 

 

 

MILITARY RETIREMENT

 

 

 

OTHER (Show Source)

 

 

 

OTHER (Show Source)

 

 

 

7B. ANNUAL INCOME (Read Paragraphs 2 and 4 of the EVR Instructions)

If no income was received from a particular source, write "0" or "none". VA WILL INTERPRET A BLANK SPACE AS "NONE" OR "0."

NOTE: Report annual income for the dates indicated. If no dates are shown above the columns that follow, then report last calendar year (January through December) income in the left-hand column and current calendar year income in the right-hand column.

SOURCE

FROM:

FROM:

 

 

 

THRU:

THRU:

 

 

 

GROSS WAGES FROM

$

$

ALL EMPLOYMENT

TOTAL INTEREST AND

 

 

DIVIDENDS

 

 

 

 

 

ALL OTHER

 

 

(Show Source)

 

 

 

 

 

ALL OTHER

 

 

(Show Source)

 

 

 

 

 

7C. DID ANY INCOME CHANGE (Increase/Decrease) DURING PAST 12 MONTHS? (Answer "NO" if there were no income changes or if the only change was a Social Security/VA cost-of-living adjustment. Answer "YES" if there were any other income changes or if you received any NEW source of income or any ONE-TIME income)

 

YES

 

NO

(If "YES", complete Items 7D through 7F. If "NO", go to Item 7G.)

7D. WHAT INCOME CHANGED? (Show what income changed, for example, wages, city pension, etc.)

7E. WHEN DID THE INCOME CHANGE?

(Show the dates you received any new income or the date income changed)

7F. HOW DID INCOME CHANGE? (Explain what happened; for example, quit work, got raise, received inheritance)

 

7G. NET WORTH (Read Paragraph 5 of the EVR Instructions)

 

 

 

SOURCE

 

SURVIVING SPOUSE

 

 

CASH/NON- INTEREST-BEARING BANK ACCOUNTS

$

 

 

 

 

 

INTEREST-BEARING BANK ACCOUNTS

 

 

 

 

 

IRA'S, KEOGH PLANS, ETC.

 

 

 

 

 

STOCKS, BONDS, MUTUAL FUNDS, ETC.

 

 

 

 

 

REAL PROPERTY (Not your home)

 

 

 

 

 

ALL OTHER PROPERTY

 

 

 

 

 

8.FAMILY MEDICAL EXPENSES (Read Paragraph 6 of the EVR Instructions)

Normally, medical expenses are reported at the end of the year. If you are using this form as your annual Eligibility Verification Report and Paragraph 6 of the EVR Instructions indicates that you should report medical expenses, use VA Form 21P-8416, Medical Expense Report, to report your medical expenses. If you are using this form as a supplement to a pending claim, you do not need to report medical expenses. If entitlement is established, you will have an opportunity to report your medical expenses at the end of the year.

9.SURVIVING SPOUSE'S EDUCATIONAL AND VOCATIONAL REHABILITATION EXPENSES (Read Paragraph 7 of the EVR Instructions). Show amounts paid by you during the past 12 months. DO NOT REPORT CHILDREN'S EXPENSES.

$

10A. SIGNATURE OF PAYEE (Read paragraph 9 of the EVR Instructions before signing)

10B. DATE SIGNED

10C. TELEPHONE NUMBERS (Include Area Code)

DAYTIME

EVENING

 

 

PENALTY: The law provides severe penalties which include fine or imprisonment, or both, for the willful submission of any statement or evidence of a material fact, knowing it is false, or fraudulent acceptance of any payment to which you are not entitled.

VA FORM 21P-0518-1, JUN 2018

PAGE 2

How to Edit Va Form 21 0518 1 Online for Free

It's simple to fill out the improved va spaces. Our software can make it almost effortless to prepare any sort of PDF. Down below are the primary four steps you need to follow:

Step 1: The initial step will be to pick the orange "Get Form Now" button.

Step 2: As soon as you've entered the editing page improved va, you should be able to see each of the actions readily available for your form at the top menu.

The PDF form you are going to complete will cover the following parts:

portion of blanks in fillable va form 21 10210

Write the expected particulars in the I HAVE NOT REMARRIED SINCE THE, I REMARRIED ON, Date AND I AM STILL MARRIED You, married Enter the date you married, I REMARRIED AFTER THE VETERAN DIED, You remarried but you are not, NUMBER OF UNMARRIED DEPENDENT, IN YOUR CUSTODY, NOT IN YOUR CUSTODY, AMOUNT CONTRIBUTED DURING PAST, A ARE YOU A PATIENT IN A NURSING, YES, If Yes Complete Items B thru D If, B SHOW THE DATE YOU ENTERED THE, and C ENTER THE NAME COMPLETE ADDRESS part.

Filling out fillable va form 21 10210 step 2

You have to write particular details inside the segment DID YOU RECEIVE ANY WAGES OR WERE, YES, DO YOU RECEIVE ANY OTHER VA, YES, If Yes write in the VA file number, VA FORM JUN, SUPERSEDES VA FORM APR WHICH, and Page.

Entering details in fillable va form 21 10210 step 3

Be sure to describe the rights and responsibilities of the parties in the If no income or net worth was, SURVIVING SPOUSE, SOURCE, SOCIAL SECURITY, US CIVIL SERVICE, US RAILROAD RETIREMENT, MILITARY RETIREMENT, OTHER Show Source, OTHER Show Source, B ANNUAL INCOME Read Paragraphs, If no income was received from a, FROM, THRU, FROM, and THRU space.

fillable va form 21 10210 If no income or net worth was, SURVIVING SPOUSE, SOURCE, SOCIAL SECURITY, US CIVIL SERVICE, US RAILROAD RETIREMENT, MILITARY RETIREMENT, OTHER Show Source, OTHER Show Source, B ANNUAL INCOME Read Paragraphs, If no income was received from a, FROM, THRU, FROM, and THRU blanks to fill out

Finalize by reviewing the next fields and typing in the required details: C DID ANY INCOME CHANGE, YES, If YES complete Items D through F, D WHAT INCOME CHANGED Show what, E WHEN DID THE INCOME CHANGE Show, F HOW DID INCOME CHANGE Explain, G NET WORTH Read Paragraph of the, SOURCE, SURVIVING SPOUSE, CASHNON INTERESTBEARING BANK, INTERESTBEARING BANK ACCOUNTS, IRAS KEOGH PLANS ETC, STOCKS BONDS MUTUAL FUNDS ETC, REAL PROPERTY Not your home, and ALL OTHER PROPERTY.

Completing fillable va form 21 10210 step 5

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Step 4: You will need to generate as many duplicates of your form as you can to remain away from future misunderstandings.

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