Va Form 26-1880 - Request For A Certificate Of Eligibility

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OMB Control No. 2900-0086
Respondent Burden: 15 minutes
Expiration Date: 12/31/2019
FOR VA USE ONLY
MAIL COMPLETED APPLICATION TO
THE REGIONAL LOAN CENTER OF
COE REF. NO.
JURISDICTION. SEE PAGE 3 FOR
REQUEST FOR A CERTIFICATE OF ELIGIBILITY
REGIONAL LOAN CENTER ADDRESSES.
IMPORTANT: For faster processing, VA encourages you to visit the eBenefits portal at
for your Certificate of Eligibility, or contact the lender
of your choice to submit an application electronically. In most cases, an eligibility determination can be made instantly.
NOTE: Please read information on page 2 before completing this form. If additional space is required, attach a separate sheet.
1. NAME OF VETERAN (First, Middle, Last)
3. SOCIAL SECURITY NUMBER
2. DATE OF BIRTH
4B. NAME(S) USED DURING MILITARY SERVICE (If different from name in Item 1)
4A. DID YOU SERVE UNDER ANOTHER NAME?
YES
NO
(If "Yes," complete Item 4B)
5. DAYTIME TELEPHONE NUMBER (Include Area Code)
6. EMAIL ADDRESS (If applicable)
7. ADDRESS (Number and street or rural route, city or P.O., State and ZIP Code)
8B. VA CLAIM NUMBER (If known)
8A. WERE YOU DISCHARGED, RETIRED, OR SEPARATED FROM SERVICE BECAUSE OF DISABILITY?
YES
NO
MILITARY SERVICE (SEE INSTRUCTIONS FOR PROOF OF SERVICE ON THE NEXT PAGE)
9A. ARE YOU CURRENTLY ON ACTIVE DUTY? (If you currently serving on active duty, leave the "Date Separated" field blank.)
YES
NO
IMPORTANT: Please provide your dates of service. In
many cases eligibility can be established based on data in
SERVICE NUMBER
VA systems. However, it is recommended that proof of
BRANCH OF
DATE
OFFICER OR
DATE ENTERED
(If different from
service be provided, if readily available. Proof of service
SERVICE
SEPARATED
ENLISTED
Social Security Number)
is required for persons who entered service after
September 7, 1980 and were discharged after serving less
than 2 years.
9B. ACTIVE SERVICE - Do not include any periods
of Active Duty for Training or Active Guard Reserve
service. Do include any activation for duty under
Title 10 U.S.C. (e.g. Reserve or Guard unit mobilized)
9C. RESERVE OR NATIONAL GUARD SERVICE
Include any periods of Active Duty for Training
(ADT) or Active Guard Reserve service. Do not
include any activation for duty under Title 10
U.S.C. (e.g. Reserve or Guard unit mobilized)
PREVIOUS VA LOANS (SEE INSTRUCTIONS ON THE NEXT PAGE - Attach a separate sheet if information for all homes will not fit in Item 10)
10A. DO YOU NOW OWN ANY HOME(S) PURCHASED OR
10B. DATE OF LOAN
10C. STREET ADDRESS
10D. CITY AND STATE
REFINANCED WITH A VA-GUARANTEED LOAN?
(Month and Year)
YES (If "Yes," complete Items 10B through 10D)
NO (If "No," skip to Item 14)
NOT APPLICABLE (NA) - I HAVE NEVER OBTAINED A
VA-GUARANTEED HOME LOAN (If "NA," skip to Item 14)
11B. DATE OF LOAN
11A. ARE YOU APPLYING FOR THE ONE-TIME ONLY
11C. STREET ADDRESS
11D. CITY AND STATE
RESTORATION OF ENTITLEMENT TO PURCHASE
(Month and Year)
ANOTHER HOME?
YES
NO (If "Yes," complete Items 11B through 11D)
12A. ARE YOU APPLYING FOR A RESTORATION OF
12D. CITY AND STATE
12B. DATE OF LOAN
12C. STREET ADDRESS
ENTITLEMENT TO OBTAIN A REGULAR (CASH-OUT)
(Month and Year)
REFINANCE ON YOUR CURRENT HOME?
YES
NO (If "Yes," complete Items 12B through 12D)
13A. ARE YOU REFINANCING AN EXISTING VA LOAN TO
13B. DATE OF LOAN
13C. STREET ADDRESS
13D. CITY AND STATE
OBTAIN A LOWER INTEREST RATE WITHOUT
(Month and Year)
RECEIVING ANY CASH PROCEEDS (IRRRL)?
YES
NO (If "Yes," complete Items 13B through 13D)
I CERTIFY THAT the statements in this document are true and complete to the best of my knowledge.
14B. DATE SIGNED
14A. SIGNATURE OF VETERAN (Do NOT print)
FEDERAL STATUTES PROVIDE SEVERE PENALTIES FOR FRAUD, INTENTIONAL MISREPRESENTATION, CRIMINAL CONNIVANCE OR
CONSPIRACY PURPOSED TO INFLUENCE THE ISSUANCE OF ANY GUARANTY OR INSURANCE BY THE SECRETARY OF VETERANS AFFAIRS
DATE RETURNED
FOR VA USE ONLY (Please do not write below this line)
REASON(S) FOR RETURN
26-1880
SUPERSEDES VA FORM 26-1880, NOV 2014,
Page 1
VA FORM
WHICH WILL NOT BE USED.
DEC 2016

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