The following information about this VA form comes from the VA forms database, and any changes are updated here nightly. Contact the form administration for further information.
Link to form
http://www.vba.va.gov/pubs/forms/VBA-21-0966-ARE.pdf
Form number
21-0966
Row ID
5382
Form title
Intent To File A Claim For Compensation and/or Pension, or Survivors Pension and/or DIC
Issue date
Revision date
Form administration
VBA
Number of pages
1
Deleted
False
Form name
Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC
Form Language
English
Related to
Benefits
VA disability compensation
VA benefits for spouses, dependents, survivors, and family caregivers
VA pension benefits
When to use

Use VA Form 21-0966 if you’re still gathering information to support your claim, and want to start the filing process. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.

Helpful links
How to file a VA disability claim
Learn about the steps for filing a claim for disability compensation or increased disability compensation. Note: If you file your disability claim online, you don’t need to submit a paper Intent to File form.
How to apply for a VA pension as a Veteran
Find out how to apply for tax-free VA pension benefits as a Veteran. Note: If you apply online for pension benefits, you still need to submit VA Form 21-0996 as your intent to file.