VA Form 28-1905m: Request and Authorization for Supplies and Direct Reimbursement

VA Form 28-1905m PDF Details

You may complete the form online or by hand.

Signature: the claimant's signature in Section III verifies that the requested items are needed or required.

Direct reimbursement: the claimant's signature also verifies the item(s) or service(s) were received on the dates listed in Item 11.

Employer: signature from the training facility or employer representative is not necessary if the VA case manager determines goods and/or services are needed or required.

Mail to: Veteran Readiness and Employment (VR&E) Intake Center, Department of Veterans Affairs, P.O. Box 5210, Janesville, WI 53547-5210.