VA Form 21P-4706b at a glance
What it is: VA Form 21P-4706b is the VA Fiduciary's Account.
Who signs: Enter the DATE in 7. and sign in ink under 8. SUBMITTED BY (Signature and title of fiduciary).
The fiduciary must account for all VA funds received on behalf of the beneficiary as VA fiduciary.
What to bring and attach to VA Form 21P-4706b
Attach detailed monthly financial (bank) statements for the entire accounting period to support the transactions noted on this accounting.
The fiduciary must keep receipts and other documentation of expenses because VA may need to examine them during the audit of this accounting.
A filled-in VA Form 21P-4706b example: a fiduciary accounts for one year
How to fill out VA Form 21P-4706b, box by box
Fiduciary, veteran or beneficiary, and accounting period
Enter the Name and Address of Fiduciary, the Name of Veteran (First-Middle-Last), the Name of Beneficiary (If not veteran) and the VA File Number.
Under ACCOUNTING PERIOD, fill in FROM and TO.
Items 1 through 8 are to be completed by the fiduciary and returned to the VA Fiduciary Hub.
Item 1. Money received
On line I, Total received, add lines 1A thru 1H; the * on it is the same * as on 4. ASSETS AT END OF PERIOD and on the form's note. NOTE: Pursuant to the signed Fiduciary Agreement (VA Form 21P-4703), this is a complete accounting of all funds received for the beneficiary.
For AMOUNT RECEIVED FROM OTHER SOURCES, list them in Items 1E thru 1H.
Show monthly amount where indicated, in addition to amount for accounting period.
2. Money spent
Under 2. Money spent, the lines are Room and board/rent, Clothing, Entertainment, Personal use, Dependent (s) support, Fiduciary fee if approved by VA and Other (Specify).
On line M, TOTAL SPENT, add lines 2A thru 2L.
Funds under management and assets at end of period
For 3. TOTAL FUNDS UNDER MANAGEMENT AT END OF PERIOD, subtract 2M from 1I.
Under 4. ASSETS AT END OF PERIOD, enter the TOTAL AMOUNT OF CHECKING ACCOUNT(S), the TOTAL AMOUNT OF SAVINGS ACCOUNT(S), the TOTAL AMOUNT OF CERTIFICATE(S) OF DEPOSIT and the TOTAL PURCHASE PRICE OF SAVINGS BONDS LISTED ON REVERSE.
For the TOTAL PURCHASE PRICE OF SAVINGS BONDS LISTED ON REVERSE, complete reverse for total in this field.
Mark Yes or No for (1) Were additional bonds purchased during this accounting period? and (2) Were savings bonds cashed during this accounting period?
Under OTHER, list outstanding checks or other issues that impact the total assets.
5. TOTAL ASSETS must equal Item 3.
Item 6, remarks
Under 6. REMARKS, if needed you may attach additional sheets and key responses to item numbers.
Date and submitted by
You certify that this is a true account of the beneficiary's estate for the period stated, to the best of your knowledge and belief.
Enter the DATE in 7. and sign in ink under 8. SUBMITTED BY (Signature and title of fiduciary).
9. Background information
Answer the questions in 9. BACKGROUND INFORMATION if you are an individual appointed to serve as fiduciary for the beneficiary named on page 1 of this form.
The questions pertain to your personal criminal and credit history.
You are not required to respond to these questions if you are serving as VA fiduciary in one of the following capacities for the beneficiary named on the first page of this form (the reverse): administrator of a facility, company or corporation, court-appointed fiduciary who is also appointed by VA.
Failure to provide a response may impact your ability to serve as a VA fiduciary.
Initial the box to certify that during this accounting period, you have not been convicted of any offense under Federal or State law, which resulted in imprisonment for more than one year.
Initial the box to certify that during this accounting period, you did not default on a debt, were not the subject of collection action by a creditor and did not file bankruptcy.
10. Explanation of background information
Enter 10. EXPLANATION OF BACKGROUND INFORMATION if necessary.
Section II, certification of U.S. savings bonds
Under SAVINGS BONDS, enter the LINE NO., SERIAL NUMBER, DATE OF PURCHASE and PURCHASE PRICE.
Sign in ink and enter the DATE to certify that the savings bonds listed are the property of the estate of the beneficiary and are in your custody and control.
More rules for VA Form 21P-4706b
You are required to respond (38 U.S.C. 5701) to obtain or retain benefits.
Failure to furnish the requested information may result in the suspension of payments and/or the appointment of a successor fiduciary.
Sources
[1] VA Form 21P-4706b (OCT 2024), VA Fiduciary's Account, Department of Veterans Affairs (the Official source link on this page).
