Va Form 21-535 - Application For Dependency And Indemnity Compensation By Parent(S) Page 2
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10H. How can I assign someone to act as my
or VA Form 22a, Appointment of Individual as Claimant's
representative?
Representative. You may also download these forms at
If you have already
A representative can be an accredited member of an
designated a representative, no further action is required
accredited organization or other service organization that
on your part.
the Secretary of Veterans Affairs recognizes, an agent
recognized by VA, or a licensed lawyer. If you appeal the
I. What if I believe that VA has made an error in
decision, agents and attorneys can charge you for services
processing or deciding my benefits?
that you receive from them only after the Board of
You can ask for a personal hearing at any time during the
Veterans' Appeals (BVA) gives you its final decision
processing of your claim. That means you can ask for the
about your application. That means you can use an
hearing while VA is processing your claim or after VA has
attorney during any stage of your application for benefits;
made a decision. You should contact the nearest VA
however, the agent or attorney cannot charge you for
regional office and tell them that you want a personal
services unless you are trying to resolve a dispute with VA
hearing on your case. Someone in the local VA regional
after BVA has made a decision about your claim.
office will arrange a time and a place for your hearing. At
If you want to use a representative to help you with your
this hearing, you may bring witnesses. VA will record
application, contact the nearest VA regional office.
whatever you and your witnesses say during the hearing
Depending on the type of representative you want to
and include it in the official record. VA will furnish the
designate, we will send you one of the following forms:
hearing room and officials, and prepare a transcript of the
VA Form 21-22, Appointment of Veterans Service
hearing. VA cannot pay your expenses or the expenses of
Organization as Claimant's Representative,
anyone you want to bring with you to the hearing.
Privacy Act Notice: The VA will not disclose information collected on this form to any source other than what has been
authorized under the Privacy Act of 1974 or Title 5, Code of Federal Regulations 1.526 for routine uses (i.e., civil or criminal
law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the
United States, litigation in which the United States is a party or has an interest, the administration of VA programs and
delivery of VA benefits, verification of identity and status, and personnel administration) as identified in the VA system of
records, 58VA21/22/28, Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records - VA,
and published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. Giving us your
SSN account information is mandatory. Applicants are required to provide their SSN under Title 38 USC 5101 (c) (1). The
VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by
Federal Statute of law in effect prior to January 1, 1975, and still in effect. The requested information is considered relevant
and necessary to determine maximum benefits under the law. Information that you furnish may be utilized in computer
matching programs with other Federal or state agencies for the purpose of determining your eligibility to receive VA
benefits, as well as to collect any amount owed to the United States by virtue of your participation in any benefit program
administered by the Department of Veterans Affairs.
Respondent Burden: We need this information to determine eligibility for death benefits and accrued benefits under 38 U.S.
C. 1121, 1310, 1315, and 5121. Title 38, United States Code, allows us to ask for this information. We estimate that you
will need an average of 1 hour and 12 minutes to review the instructions, find the information and complete this form. VA
cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required
to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the
OMB Internet Page at If desired, you can call 1-800-827-1000 to get information on
where to send comments or suggestions about this form.
General Instructions
Page 2
VA FORM 21-535, FEB 2012
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