VA Form 21P-534A Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In-Service Death Only

VA Form 21P-534A Instructions

1. Write down the veteran's full name and Social Security Number (SSN).
2. State your full name, social security number, date of birth, and indicate if you have lived continuously with the veteran from the date of marriage to the date of death (for surviving spouses only).
3. Give the reason, the duration, and the date of separation (if applicable).
4. Provide information on children of the deceased veteran in your custody (i.e., their full names, dates of birth, social security numbers, places of birth, and their relationship to you).
5. Write down your current mailing address and telephone numbers. If the address is changed, mention it in the appropriate box.
6. Indicate if you want the VA payment to be directly deposited into your financial account.
7. Write down the type of your account, its number, and the transit number of the financial institution.
8. Certify that the statements on the form are complete and true to the best of your belief and knowledge, sign the document, and write down the actual date.

The last items on the form are to be completed by the Military Casualty Assistance Officer - a representative assigned to you to assist in completing the form. The Casualty Assistance Officer (CAO) is required to write down the full name, rank, telephone number, and e-mail address.