Va Form 21-527ez - Application For Pension - Department Of Veteran Affairs Page 2
Download a blank fillable Va Form 21-527ez - Application For Pension - Department Of Veteran Affairs in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Va Form 21-527ez - Application For Pension - Department Of Veteran Affairs with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4SECTION IV: MARITAL STATUS
(MUST COMPLETE)
18A. WHAT IS YOUR MARITAL STATUS? (Check one)
MARRIED
DIVORCED
WIDOWED
NEVER MARRIED
(Skip to Section VI if never married)
TELL US ABOUT YOUR MARRIAGE/PREVIOUS MARRIAGES
18B. HOW MANY TIMES HAVE YOU BEEN MARRIED (including current marriage)?
19D. HOW MARRIAGE
19E. DATE (month, day,
19B. TO WHOM
19C. TYPE OF MARRIAGE
19A. DATE (month, day, year) AND PLACE OF
TERMINATED
year) AND PLACE
MARRIED
(ceremonial, common-law,
MARRIAGE (city/state or country)
(death, divorce, marriage has not
MARRIAGE TERMINATED
(first, middle, last name)
proxy, tribal, or other)
been terminated)
(city/state or country)
19F. IF YOU INDICATED "OTHER" AS TYPE OF MARRIAGE IN ITEM 19C, PLEASE EXPLAIN:
SECTION V: CURRENT MARITAL INFORMATION
(COMPLETE ONLY IF YOU ARE CURRENTLY MARRIED)
Note - Skip to Section VI if not currently married.
TELL US ABOUT YOUR SPOUSE'S MARRIAGE/PREVIOUS MARRIAGES
20. HOW MANY TIMES HAS YOUR SPOUSE BEEN MARRIED (including current marriage)?
21D. HOW MARRIAGE
21E. DATE (month, day,
21B. TO WHOM
21C. TYPE OF MARRIAGE
21A. DATE (month, day, year) AND PLACE OF
TERMINATED
year) AND PLACE
MARRIED
(ceremonial, common-law,
MARRIAGE (city/state or country)
(death, divorce, marriage has not
MARRIAGE TERMINATED
(first, middle, last name)
proxy, tribal, or other)
been terminated)
(city/state or country)
21F. IF YOU INDICATED "OTHER" AS TYPE OF MARRIAGE IN ITEM 21C, PLEASE EXPLAIN:
22A. WHAT IS YOUR SPOUSE'S DATE OF
22B. WHAT IS YOUR SPOUSE'S
22C. IS YOUR SPOUSE
22D. WHAT IS YOUR SPOUSE'S VA
BIRTH? (month, day, year)
SOCIAL SECURITY NUMBER?
ALSO A VETERAN?
FILE NUMBER (if any)?
YES
NO
22F. WHAT IS YOUR SPOUSE'S ADDRESS? (Number and street or rural route, city or P.O.,
22E. DO YOU LIVE WITH YOUR SPOUSE?
State, ZIP Code and country)
(If "Yes," skip to Section VI)
YES
NO
(If "No," complete Items 22F - 22H)
22G. TELL US THE REASON WHY YOU ARE NOT LIVING WITH YOUR SPOUSE
22H. HOW MUCH DO YOU CONTRIBUTE MONTHLY TO YOUR
(i.e.; illness, work, etc.)
SPOUSE'S SUPPORT?
$
SECTION VI: DEPENDENT CHILDREN
(COMPLETE IF YOU HAVE DEPENDENT CHILDREN)
Note - Skip to Section VII if you have no dependent children.
(Check all that apply)
23A. NAME OF DEPENDENT
23B. DATE AND
23C. SOCIAL
23G.
23H.
23I.
23J. CHILD
CHILD
PLACE OF BIRTH
SECURITY
23D.
23E.
23F.
18-23 YEARS
SERIOUSLY
CHILD
PREVIOUSLY
(First, middle initial, last)
(city, state or country)
NUMBER
BIOLOGICAL
ADOPTED
STEPCHILD
OLD (in school)
DISABLED
MARRIED
MARRIED
Note - In Items 24A through 24D, tell us about the children listed in Item 23A who do not live with you.
24B. CHILD'S COMPLETE ADDRESS
24D. MONTHLY AMOUNT YOU
24A. NAME OF DEPENDENT CHILD
24C. NAME OF PERSON THE CHILD
(Number and street or rural route, city or P.O., city,
CONTRIBUTE TO THE CHILD'S
(First, middle initial, last)
LIVES WITH (If applicable)
State, ZIP Code and country)
SUPPORT
$
$
$
VA FORM 21-527EZ, JUN 2014
Page 6
ADVERTISEMENT
0 votes
Related Articles
Related forms
Va Form 21-4182 - Application For Dependency And Indemnity Compensation Or Death Pension (including Accrued Benefits And Death Compensation Where Applicable) From The Department Of Veterans Affairs
Legal
Related Categories
Parent category: Legal