VA Form 21-526C Pre-discharge Compensation Claim

VA Form 21-526C Instructions

The VA Form 21-526C is distributed without filling guidelines. The instructions for completing the form are provided below.

How to Fill Out VA Form 21-526C?

1. Choose either Benefits Delivery at Discharge (BDD) Claims or Quick Start Claims.
2. Section I. Personal information. Provide your name, place of separation, social security number, date of birth, sex, address, telephone number, work and personal email address in the corresponding boxes 1-8b. Provide the name and relationship to the next of kin, as well as their address and telephone number in Boxes 9a-c. If you have ever filed a claim with the VA, provide the VA file number in this section.
3. Section II. Service information. Mark Box 12a if you have served under another name. The name must be provided in box 12b. Enter the date of entering the current period of active service in box 13a. Enter your branch of service in Box 13b. Provide your anticipated date of release in Box 13c. If you have served in a combat zone since 9/11/2001, mark Box 13d.
4. If you are currently on active duty under the authority of the title 10, indicate this information in box 14a. Provide the date of activation in box 14b. Enter the name and address of current reserve or national guard unit in Box 15a. Enter your current unit telephone number in Box 15b. If you have any additional periods of active service, indicate this in Box 16a, and provide the date of previous active service in Box 16b.
5. Section III. Information on military retired pay. If you anticipate receiving a retired pay in the future, indicate this in Box 17a and show the type of the pay in Box 17b. If you expect to receive a separation or service pay, indicate this in Box 18a. Give the amount and the type in Boxes 18b and 18c. If you do not wish to receive the VA compensation in lieu of military retired pay, mark the Box 19.
6. Section IV. Direct deposit information. Give the account number in box 20. Enter the name of a financial institution in Box 21. Enter the routing or transit number in Box 22.
7. Section V. Certifications and signature. Sign in Box 23a and date in box 23b.
8. Section VI. Signature of witnesses. Have the witness sign in Boxes 24a and 25a and date in Boxes 24b and 25b.

VA 21-526C Related Forms

The VA 21-526C belongs to the VA 21-526 forms series. The other forms in the series include:

1. VA Form 21-526, Veteran's Application for Compensation and/or Pension;
2. VA Form 21-526B, Veteran's Supplemental Claim for Compensation;
3. VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.