Form 21-0538 at a glance
What it is: Mandatory Verification of Dependents is the information needed to determine continued eligibility for an additional allowance for your spouse and/or child(ren).
Who signs: 14A. SIGNATURE OF VETERAN is REQUIRED: I HEREBY CERTIFY THAT the information I have given on this form is true and correct to the best of my knowledge and belief.
A filled-in Form 21-0538 example: a veteran confirms no dependent changed
How to fill out Form 21-0538, box by box
Veteran's identification information
You may complete the form online or by hand. If completed by hand, print the information requested in ink, neatly and legibly, insert one letter per box, and completely fill in each applicable check box to help expedite processing of the form.
In Box 1, enter the veteran's name (First, Middle Initial, Last).
In Box 2, enter the social security number; in Box 3, the VA file number (If applicable); in Box 4, the date of birth (MM/DD/YYYY).
In Box 5, enter the current mailing address (Number and street or rural route, P.O. Box, City, State, ZIP Code and Country).
In Box 6, enter the telephone number (Include Area Code); in Box 7, enter the e-mail address.
I agree to receive electronic correspondence from VA in regards to my claim.
Status certification
Box 8, HAS THE STATUS OF YOUR DEPENDENT(S) CHANGED? If "Yes," complete the section (Section III or Section IV) that refers to the dependent(s) whose status has changed. If "No," sign this form (Section V) and disregard the remaining sections of this form.
If you have additional dependents not listed on the letter attached to this form, complete and submit VA Form 21-686c, Application Request to Add and/or Remove Dependents, and if claiming a child aged 18-23 years and in school, complete VA Form 21-674, Request for Approval of School Attendance.
Change in spouse status
Box 9, HOW DID STATUS CHANGE? For MARRIAGE ENDED, enter the DATE ENDED (MM/DD/YYYY) and mark the REASON MARRIAGE ENDED: ANNULMENT, DIVORCE or DECLARED VOID.
For DEATH, enter the DATE OF DEATH (MM/DD/YYYY).
Change in child(ren)'s status
In 10A, enter the CHILD'S NAME; in 10B, mark HOW STATUS CHANGED: DEATH OF CHILD with the DATE OF DEATH (MM/DD/YYYY), MARRIAGE OF CHILD with the DATE OF MARRIAGE (MM/DD/YYYY), or ADOPTION OUT OF FAMILY with the DATE OF ADOPTION (MM/DD/YYYY).
NOTE: If your child has been adopted out of your family, input the date the adoption was finalized. If you have more than four children whose status has changed, use a separate VA Form 21-0538.
For a stepchild, mark STEPCHILD IS NO LONGER A MEMBER OF HOUSEHOLD and enter the LAST DATE STEPCHILD WAS A MEMBER OF HOUSEHOLD (MM/DD/YYYY). Do not fill in this check box if you live apart from the stepchild but are still providing at least half of the child's support or if you live apart from the stepchild because of medical reasons or because you or the child are incarcerated, attending school, or fulfilling a military service obligation.
SECTION IV: CHANGE IN CHILD(REN)'S STATUS (CONTINUED) has 11A, 12A and 13A for the CHILD'S NAME and 11B, 12B and 13B for HOW STATUS CHANGED.
Certification and signature
In 14B, enter the DATE SIGNED (MM/DD/YYYY).
More rules for Form 21-0538
Enter International Phone Number (If applicable).
You will need an average of 10 minutes to review the instructions, find the information and complete this form.
Common questions about Form 21-0538
Where do I file it?
INSTRUCTIONS: Before completing this form, read the Privacy Act and Respondent Burden on page 2. For more information, contact Ask VA at https://ask.va.gov/, or call toll-free at 1-800-827-1000 (TTY: 711). VA forms are available at www.va.gov/vaforms. After completing the form, mail to: Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547- 4444.
Is there a 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 to be false, or for the fraudulent acceptance of any payment to which you are not entitled.
Sources
[1] VA Form 21-0538 (JAN 2024 supersedes FEB 2021), Mandatory Verification of Dependents, U.S. Department of Veterans Affairs (the Official source link on this page).
