21-0966

Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or D.I.C. (VA Form 21-0966)

Agency
VA
Revision
2026-05-21
Fillable fields
49
Fill 21-0966 online
21-0966

Form 21-0966: Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or D.I.C. (VA Form 21-0966)

Use VA Form 21-0966 if you’re still gathering information to support your claim and want to start the filing process. This form is for disability, Veterans pension, survivors pension, or Dependency and Indemnity Compensation (D.I.C.) claims. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.

How to fill out Form 21-0966 online

  1. 1

    Open the form

    Press Fill 21-0966 online. The official form opens in your browser, ready to type into.

  2. 2

    Fill in the fields

    Click a field and type. Move through the form at your own pace, nothing is sent anywhere until you choose.

  3. 3

    Download or print

    Save the filled form as a PDF or print it. You do not need an account to download it.

Why fill Form 21-0966 on indox

You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.

  • Fill the form right in your browser, no software to install
  • Free to fill and free to download, with no account
  • The official blank straight from the VA, not a copy someone retyped
  • Works on a phone, tablet or computer

Do it all with indox

View all 123 tools