Fill VA Form 21-4138 online
Statement in Support of Claim
or choose your own copy:
- ✓ Official current version
- ✓ Free download, no account
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- ✓ Never uploaded
VA Form 21-4138 in short
VA Form 21-4138 is a blank statement form for adding written information to a VA claim. Veterans and other beneficiaries use it when VA asks for more details, or when their explanation does not fit on the main claim form. VA offers an online version, so you can submit the statement on VA.gov instead of mailing the paper form.
| Issued by | U.S. Department of Veterans Affairs (VA), Veterans Benefits Administration |
|---|---|
| Current version | Rev. July 2024 (checked 2026-10-25) |
| Who fills it in | The veteran or beneficiary named on the claim. VA's form page says it is for people asked to share more information by another VA form or process. Examples it gives: family or financial details for a pension, Dependency and Indemnity Compensation (DIC) or accrued benefits claim, reporting a reimbursement received after a medical expense report, and details about claimed disabilities that do not fit on the original claim form. |
| Who receives it | VA, at the Evidence Intake Center in Janesville, Wisconsin, which scans the statement into the claim file. |
| Where to send it | Online: VA says you can submit your statement in support of claim online on VA.gov instead of sending the paper form. By mail, the form says to send it to: Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. |
| Deadline | The form has no deadline of its own. If VA asked you for information in a letter, follow the date in that letter. The statement does not replace the claim or decision review form that starts a claim or appeal. |
| Official links | Official page · Official PDF |
What changed
The JUL 2024 edition replaced the JUN 2021 edition, which the form marks as superseded. VA did not publish a list of changes.
How to fill out VA Form 21-4138, line by line
| Section I, item 1 | Veteran/beneficiary's name First name, middle initial and last name of the veteran or beneficiary the statement is about. |
| Section I, items 2 to 5 | SSN, VA file number, date of birth, service number The veteran's Social Security number, plus the VA file number and service number if they apply. These help VA match the statement to the right claim file. Dates use MM/DD/YYYY. |
| Section I, items 6 and 7 | Telephone number and email A daytime phone number with area code. There is a separate box for an international number. Email is optional. |
| Section I, item 8 | Mailing address Your current mailing address including apartment or unit number and country. |
| Section II | Remarks Write your statement here. It continues on page 2. Say clearly which claim or issue it relates to and stick to facts such as dates, places and names. If you are answering a VA letter, answer each question VA asked. |
| Section III, items 9 and 10 | Signature and date signed The veteran or beneficiary signs and dates the form. The form marks the signature as required. Signing certifies the statements are true and correct to the best of your knowledge. |
Common mistakes to avoid
- Using this form to file a new claim or to ask for a decision review. VA has separate forms for those, such as VA Form 21-526EZ for disability compensation and VA Form 20-0995 for a Supplemental Claim.
- Leaving out the veteran's Social Security number or VA file number, which makes it harder for VA to match the statement to the claim file.
- Forgetting to sign and date item 9. The form marks the signature as required.
- Using this form for a witness or buddy statement. VA's form page points people to VA Form 21-10210, Lay/Witness Statement, for that.
- Not answering every question in the VA letter that asked for the statement.
- Mailing the original only. Keep a copy of everything you send to VA.
Questions about VA Form 21-4138
Can I submit VA Form 21-4138 online?
Yes. VA's form page says you can submit your statement in support of claim online instead of filling out and sending the paper form.
Where do I mail VA Form 21-4138?
The form says to mail it to Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444.
Can a family member or friend use this form to support my claim?
VA's form page lists VA Form 21-10210, Lay/Witness Statement, for statements from other people supporting your claim. VA Form 21-4138 is for the veteran or beneficiary's own statement.
Is there a word limit?
The form gives a Remarks section that continues onto page 2. If you need more space, the fillable form or the online version may help. Keep the statement focused on what VA asked for.
Who can I contact with questions?
The form says you can use Ask VA at ask.va.gov or call 800-827-1000 (TTY: 711).
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Sources
Checked against the official sources on 2026-10-25. PDF Editor Hub is not affiliated with the U.S. Department of Veterans Affairs or any government agency. This page is general information, not legal or tax advice.