Va Form 26 6807 PDF Details

If you’re here, chances are that you’re looking for information about VA Form 26-6807 – the Veteran’s Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child. This form is used to apply for a special type of Supplemental Security Income (SSI) benefit given to dependents of deceased veterans who meet certain criteria related to their service history. In this blog post, we will provide an overview of the VA Form 26-6807, discuss who can use it and when they should do so, outline any necessary documentation associated with filing the form, and direct readers to further sources of assistance if needed.

QuestionAnswer
Form NameVa Form 26 6807
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesprintable va forms 26 6807, STATEMENT, 22B, va form 26 6807

Form Preview Example

OMB Approved No. 2900-0047 Respondent Burden 45 Minutes

FINANCIAL STATEMENT

1. FILE NO.

C-

2. LOAN NO.

IMPORTANT: Type or print all entries in ink. If more space is needed for any item, continue under Section VI, "Remarks," or attach separate sheets. If there is a co-borrower or co-applicant who is not the spouse of the borrower/applicant, a separate financial statement should be completed by that person.

SECTION I - GENERAL INFORMATION

3. NAME AND PRESENT ADDRESS OF BORROWER/APPLICANT

 

4. HOME TELEPHONE NO. (Include Area Code)

5. DATE OF BIRTH

 

(Include ZIP Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. MARITAL STATUS OF BORROWER/APPLICANT

7. SOCIAL SECURITY NO. OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BORROWER/APPLICANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. NAME OF SPOUSE

 

 

 

 

 

 

9. SPOUSE'S DATE

10. SOCIAL SECURITY NO. OF

11. AGE(S) OF DEPENDENT(S)

 

 

 

 

 

 

 

 

 

OF BIRTH

SPOUSE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INITIALS

 

13A. CO-BORROWER/SPOUSE: If you do not wish to

 

INITIALS

12A. BORROWER/APPLICANT: If you do not wish to

 

 

 

 

 

complete Items 13B and 13C please initial here

 

 

 

 

 

complete Items 12B and 12C, please initial here

 

 

 

 

 

(NOTE: Information not to be collected on a non-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

coborrower spouse)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12B. RACE/NATIONAL ORIGIN

 

 

12C. SEX

 

13B. RACE/NATIONAL ORIGIN

 

 

13C. SEX

 

 

AMERICAN INDIAN

 

HISPANIC

 

 

MALE

 

 

 

AMERICAN INDIAN

 

HISPANIC

 

 

 

MALE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALASKA NATIVE

 

 

 

 

 

 

ALASKA NATIVE

 

 

 

 

 

 

 

BLACK (Not Hispanic)

 

 

FEMALE

 

 

 

BLACK (Not Hispanic)

 

 

FEMALE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASIAN PACIFIC

 

 

 

 

 

ASIAN PACIFIC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ISLANDER

 

WHITE (Not Hispanic)

 

 

 

 

 

 

 

ISLANDER

 

 

WHITE (Not Hispanic)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.PLEASE CHECK THE APPROPRIATE BOX(ES). IF ONE OR MORE ARE CHECKED, THIS CREDIT STATEMENT MUST INCLUDE INFORMATION CONCERNING THE BORROWER/APPLICANT'S SPOUSE (OR FORMER SPOUSE IF BOX "D" IS CHECKED). IF NO BOXES ARE CHECKED, NO INFORMATION CONCERNING THE SPOUSE NEED BE FURNISHED.

A.THE SPOUSE IS OR WILL BE JOINTLY OBLIGATED WITH THE BORROWER/APPLICANT ON THE LOAN.

B.THE BORROWER/APPLICANT IS RELYING ON THE SPOUSE'S INCOME AS A BASIS FOR REPAYMENT OF THE LOAN.

C.THE BORROWER/APPLICANT IS MARRIED AND THE PROPERTY SECURING THE LOAN IS LOCATED IN A COMMUNITY PROPERTY STATE.

D.THE BORROWER/APPLICANT IS RELYING ON ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE PAYMENTS FROM A SPOUSE OR FORMER SPOUSE AS A BASIS FOR REPAYMENT OF THE LOAN.

SECTION II - EMPLOYMENT AND FINANCIAL STATUS

15. COMPLETE RECORD OF EMPLOYMENT FOR YOURSELF AND SPOUSE (Start with present position and work back 2 years)

A. NAME AND ADDRESS OF EMPLOYER

B. DATES (Month, year)

C. KIND OF JOB

D. WORK

 

 

(Mechanic, stenographer, etc.)

TELEPHONE NO.

FROM

TO

 

(1)

PRESENT

TIME

BORROWER /APPLICANT

(2)

(1)

PRESENT

TIME

SPOUSE

(2)

VA FORM

26-6807

EXISTING STOCKS OF VA FORM 26-6807, SEP 2003,

OCT 2004

 

WILL BE USED.

 

16. MONTHLY INCOME

A. GROSS SALARY

 

BORROWER/

 

SPOUSE

 

C. OTHER (Specify)

BORROWER/

 

SPOUSE

 

Include income from

 

APPLICANT

 

 

APPLICANT

 

 

 

 

 

 

 

 

(Before payroll

 

 

 

 

 

 

 

 

 

 

business or property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

after deduction of

deductions)

 

$

 

$

 

 

 

 

$

 

$

 

 

expenses. Disclosure of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

child support, alimony

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. PENSION OR

 

 

 

 

 

 

 

D. TOTAL MONTHLY

 

 

 

 

 

and maintenance

 

 

 

 

 

 

 

 

 

 

 

 

COMPENSATION

 

$

 

$

 

 

 

INCOME

$

 

$

 

 

income is optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17. ASSETS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. CASH IN BANK (Checking and savings accounts, building and

 

 

 

 

F. SAVING BONDS(Current value)

 

 

 

 

loan accounts, etc.)

 

 

 

 

$

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. CASH ON HAND

 

 

 

 

 

 

 

 

G. STOCKS AND OTHER BONDS (Current value)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C. FURNITURE AND HOUSEHOLD GOODS (Resale value)

 

 

 

 

H. REAL ESTATE OWNED(Resale value)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D. AUTOMOBILES (Resale value)

 

 

 

 

I. OTHER ASSETS (Itemize)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAKE

 

YEAR

 

MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E. TRAILERS, BOATS, CAMPERS (Resale value)

 

 

 

 

 

J. TOTAL ASSETS

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18. DEBTS

 

 

 

 

 

 

NOTE: DETAILS FOR INSTALLMENT CONTRACTS AND OTHER DEBTS (Show here ALL debts which you are required to pay in regular monthly installments, such as car, television, washing machine, payments to dealers, banks, finance companies, repayment of money borrowed for any purpose, doctor bills, hospital bills, etc. Include any alimony, child support, or separate maintenance obligations you are required to pay. If additional space is needed, use Section VI, or attach separate sheet. Do not include living expenses. If repayment of a debt is not on a monthly basis, write "0" in Column E and describe arrangements to repay in "Remarks")

 

 

 

 

 

 

 

A. NAME AND ADDRESS OF

 

B. DATE AND PURPOSE

 

C. ORIGINAL

 

 

E. AMOUNT

F. AMOUNT

 

 

ITEM

 

 

 

 

OF DEBT

 

 

 

 

D. UNPAID

 

 

 

 

 

CREDITOR

 

 

 

 

 

 

 

 

 

AMOUNT OF

 

DUE

PAST DUE

 

NO.

 

 

 

 

 

 

 

 

(Include account number,

 

BALANCE

 

 

 

 

 

(Include ZIP Code)

 

 

 

DEBT

 

MONTHLY

(If any)

 

 

 

 

 

 

 

 

if available)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

$

 

$

$

 

(2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

$

 

 

 

$

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION III - CREDIT REFERENCES AND OTHER FINANCIAL INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19. NAME AND ADDRESS OF FIRMS OR BANKS WITH WHOM YOU HAVE DONE BUSINESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A.

 

 

 

 

 

 

 

 

 

B.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C.

 

 

 

 

 

 

 

 

 

D.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20. IF YOU ARE RENTING PREMISES YOU NOW OCCUPY, COMPLETE A, B, AND C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. MONTHLY RENTAL

B. UTILITIES INCLUDED?

C. NAME AND ADDRESS OF PERSON OR FIRM RENTAL PAID TO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21A. HAVE YOU EVER BEEN

21B. DATE ADJUDICATED BANKRUPT

22A. HAVE YOU HAD A GI LOAN?

22B. NAME OF VA OFFICE WHERE

 

 

 

ADJUDICATED BANKRUPT?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOAN WAS PROCESSED

 

 

 

YES

 

NO

(If "Yes", complete

 

 

 

 

 

 

 

 

YES

 

 

(If "Yes", complete

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Item 21B)

 

 

 

 

 

 

 

 

 

 

NO Item 22B)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA FORM 26-6807, OCT 2004

SECTION IV - REAL ESTATE OWNED

(Show ALL real estate owned. Use this sheet to provide information for one property. If you own more that one property use separate blank sheets to provide the same items of information for each of your other properties.)

 

23. ADDRESS OF PROPERTY (Number, street, city, county, State)

24. PURCHASE PRICE

 

25. CURRENT MARKET VALUE OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROPERTY

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26. NAME AND ADDRESS OF MORTGAGEE (If mortgaged)

 

27. ORIGINAL AMOUNT OF MORTGAGE

 

28. UNPAID BALANCE

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29. FREQUENCY OF MORTGAGE PAYMENTS (If payment is not by

30. AMOUNT OF MORTGAGE

 

31. STATUS OF LOAN(Check)

32. AMOUNT OF

 

 

regular amortization plan, explain in Section VI, "Remarks")

 

PAYMENT

 

 

 

CURRENT

 

DELINQUENCY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(If any)

 

 

MONTHLY

 

QUARTERLY

 

 

SEMI-ANNUALLY

 

ANNUALLY

 

 

 

 

 

 

 

DELINQUENT

 

 

 

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

33. OTHER LIENS AGAINST PROPERTY, IF ANY

 

34. DO YOU OCCUPY THE PROPERTY?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

35. IF PROPERTY IS RENTED, WHAT ARE THE RENTAL TERMS?

36. AMOUNT OF AVERAGE MONTHLY INCOME YOU RECEIVE FROM THIS PROPERTY

 

 

 

 

 

 

 

 

 

 

 

 

IN EXCESS OF OPERATING EXPENSES

 

 

 

$

 

 

 

PER

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION V - ADDITIONAL DATA

 

 

 

37. NAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU (Including telephone number if available)

SECTION VI - REMARKS

38.USE THIS SPACE AND ADDITIONAL SHEETS IF NECESSARY TO SUPPLY ANY OTHER PERTINENT INFORMATION AND TO CONTINUE YOUR ANSWER TO PREVIOUS ITEMS. INDICATE ITEM NUMBER TO WHICH YOUR COMMENTS APPLY.

SECTION VII - CERTIFICATIONS

I (WE) AFFIRM THAT the information contained herein is true, correct, and complete to the best of my (our) knowledge and belief.

39A. SIGNATURE OF BORROWER/APPLICANT

39B. DATE

40A. SIGNATURE OF SPOUSE

40B. DATE

PENALTY: The law provides severe penalties which include fine or imprisonment, or both, for the willful submission of a statement or evidence of a material fact, knowing it to be false.

VA FORM 26-6807, OCT 2004

Privacy Act Notice: 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 38, Code of Federal Regulations 1.576 for routine uses (i.e., to service your loan and to evaluate your application for release of liability and, if applicable, substitution of entitlement) as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and Vendee Loan Applicant Records - VA, and published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. Giving us your SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect.

Respondent Burden: We need this information to service your loan and to evaluate your application for release of liability and, if applicable, substitution of entitlement. Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 45 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at http://www.whitehouse.gov/omb/library/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.

NOTICE TO APPLICANTS

This is notice to you as required by the Right to Financial Privacy Act of 1978 that the Department of Veterans Affairs Loan Guaranty Service or Division has a right of access to financial records held by a financial institution in connection with the consideration or administration of assistance to you. Financial records involving your transaction will be available to the Department of Veterans Affairs Loan Guaranty Service or Division without further notice or authorization but will not be disclosed or released to another Government Agency or Department without your consent except as required or permitted by law.

VOLUNTARY INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The information in Items 12A, 12B, 12C, and 13A, 13B, and 13C is requested by the Federal Government to monitor compliance by VA as a lender with Equal Credit Opportunity and Fair Housing laws. The law provides that a lender may neither discriminate on the basis of this information nor on whether or not it is furnished.

VA FORM 26-6807, OCT 2004

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1. The va form 26 6807 necessitates particular details to be entered. Ensure that the subsequent blanks are filled out:

Tips to prepare 13C stage 1

2. Once your current task is complete, take the next step – fill out all of these fields - THE SPOUSE IS OR WILL BE JOINTLY, THE BORROWERAPPLICANT IS MARRIED, THE BORROWERAPPLICANT IS RELYING, THE BORROWERAPPLICANT IS RELYING, SECTION II EMPLOYMENT AND, COMPLETE RECORD OF EMPLOYMENT FOR, A NAME AND ADDRESS OF EMPLOYER, B DATES Month year, FROM, C KIND OF JOB, Mechanic stenographer etc, D WORK, TELEPHONE NO, BORROWER APPLICANT, and PRESENT with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Completing section 2 in 13C

3. The following section focuses on SPOUSE, TIME, VA FORM, OCT, and EXISTING STOCKS OF VA FORM SEP - complete all these fields.

Stage # 3 for completing 13C

4. This next section requires some additional information. Ensure you complete all the necessary fields - MONTHLY INCOME Include income, A GROSS SALARY, Before payroll, deductions, B PENSION OR COMPENSATION, BORROWER APPLICANT, SPOUSE, C OTHER Specify, BORROWER APPLICANT, SPOUSE, ASSETS, D TOTAL MONTHLY, INCOME, A CASH IN BANK Checking and, and F SAVING BONDS Current value - to proceed further in your process!

13C writing process clarified (stage 4)

In terms of A CASH IN BANK Checking and and deductions, be certain you review things in this current part. These two are the most important ones in the PDF.

5. The final section to complete this form is integral. Ensure you fill in the displayed fields, such as Include ZIP Code, if available, DEBT, MONTHLY, If any, TOTAL, SECTION III CREDIT REFERENCES AND, NAME AND ADDRESS OF FIRMS OR, A MONTHLY RENTAL, B UTILITIES INCLUDED, C NAME AND ADDRESS OF PERSON OR, and IF YOU ARE RENTING PREMISES YOU, before submitting. In any other case, it might end up in a flawed and potentially unacceptable document!

13C completion process described (stage 5)

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