Veterans' Preference Eligibility Form (Page 3 of 4) in pdf

DOCUMENTATION REQUIRED – READ CAREFULLY

Unless a certified copy is specified, please submit photocopies of documents because they will not be returned.

A. Documentation of Service and Separation under

4) An official statement or retirement orders from a

Honorable Conditions

branch of the Armed Forces showing that the retired

serviceman was retired because of permanent,

Submit any of the documents listed below as

service-connected disability or was transferred to the

documentation, provided they are dated on or after the day

permanent disability retirement list.

of separation from active duty military service:

For spouses and mothers of disabled veterans who

1. Honorable or general discharge certificate.

checked item 10 or 12, submit the following:

2. Certificate of transfer to Navy Fleet Reserve, Marine

Corps Fleet Reserve, or enlisted Reserve Corps.

An official statement, dated 1991 or later, from the

3. Orders of transfer to retired list.

Department of Veterans Affairs or from a branch of the

4. Report of separation from a branch of the Armed

Armed Forces, certifying:

Forces.

5. Certificate of service or release from active duty,

1) the present existence of the veteran’s service-

provided honorable separation is shown.

connected disability,

6. Official statement from a branch of the Armed Forces

2) the percentage and nature of the service-connected

showing that honorable separation took place, or will

disability or disabilities (including the combined

take place within 120 days of certification by

percentage),

appropriate official of the Armed Forces.

3) a notation as to whether the service-connected

7. Notation by the Department of Veterans Affairs or a

disability is rated as permanent and total.

branch of the Armed Forces on an official statement,

Please Note: When a veteran dies on active duty, the family

described in B below, that the veteran was honorably

does not receive a DD Form 214; the family receives a DD

separated from military service.

Form 1300, Report of Casualty, on which there is no place to

8. Official statement from the Military personnel records

record the character of service. Thus, when a veteran dies on

center that official service records show that honorable

active duty, his or her service should be presumed to be

separation took place.

under honorable conditions unless the military service

B. Documentation of Service-Connected Disability;

specifically indicates otherwise.

Purple Heart; and Non-service-Connected Disability

C. Documentation of Veteran’s Death

Pension.

1. If on active military duty at time of death, submit

Submit one of the documents:

official notice, from a branch of the Armed Forces, of

1. An official statement, dated 1991 or later; from the

death occurring under honorable conditions.

Department of Veterans Affairs or from a branch of the

2. If death occurred while not on active duty, submit

Armed Forces, certifying to the present existence of

certified copy of death certificate.

the veteran’s service-connected disability.

D. Documentation of Service or Death During a War, in a

2. An official citation, document or discharge certificate,

Campaign or Expedition for which a Campaign Badge

issued by a branch of the Armed Forces, showing the

is Authorized, or During the Period Authorized, or

award to the veteran of the Purple Heart for wound or

During the Period of April 28, 1952, through July 1,

injuries received in action.

1955.

3. An official statement, dated 1991 or later; from the

Department of Veterans Affairs, certifying that the

Submit documentation of service or death during a war or

veteran is receiving a non-service-connected disability

during the period April 28, 1952, through July 1, 1955, or

pension, compensation for a service-connected

during a campaign or expedition for which a campaign

disability or disability retired pay.

badge is authorized.

Page 3 of 4

Veterans' Preference Eligibility Form Page 3

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