Centralized Intake Coversheet - …
USE THIS COVER SHEET TO SEND CLAIM MATERIALS TO THE VA CLAIMS INTAKE CENTER *** EFFECTIVE JANUARY 2017 – PLEASE DO NOT USE PREVIOUS VERSIONS***. Centralized Intake Coversheet . To: Department of Veterans Affairs Claims Intake Center
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VA DATE STAMP (DO NOT WRITE IN THIS SPACE) …
www.clientservicesnetwork.comDISABILITIES A. NAME AND LOCATION 13. LIST THE DISABILITY(IES) YOU ARE CLAIMING (If applicable, identify whether a disability is due to a service-connected disability, is due to confinement as a
INTENT TO FILE A CLAIM FOR COMPENSATION …
www.clientservicesnetwork.comTitle: 21-0966 Author: N. Kessinger Subject: INTENT TO FILE A CLAIM FOR COMPENSATION AND/OR PENSION, OR SURVIVORS PENSION AND/OR DIC (This Form Is Used to Notify VA of Your Intent to File for the General Benefit(s) Checked Below)
REQUEST PERTAINING TO MILITARY RECORDS
www.clientservicesnetwork.comStandard Form 180 (Rev. 11/2015) (Page 1) Authorized for local reproduction . Prescribed by NARA (36 CFR 1233.18 (d)) Previous edition unusable OMB No. 3095-0029 Expires 04/30/2018
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