20-10206
Freedom of Information Act (FOIA) or Privacy Act (PA) Request (VA Form 20-10206)
VA Form 20-10206 is the U.S. Department of Veterans Affairs Freedom of Information Act (FOIA) or Privacy Act (PA) Request. The instructions say the form is only used to request military records or a veteran's benefit records. They describe a FOIA request as the public's right to request access to records from Federal agencies, except those protected by the nine FOIA exemptions, and a PA request as a way for a U.S. citizen or an alien lawfully admitted for permanent residence to request access to or amendment of records on themselves from a System of Records.
The PDF is four pages: one page of instructions, then Sections I to X. Section I is for a request about yourself and Section II for a request about another person. Sections III and IV list the record types, and Sections VIII to X hold the requester, third-party and Power of Attorney signatures. VA's form page says the request can also be submitted online. You can fill out the PDF free in your browser on this page and download the result without an account.
Items 1 to 9: name, Social Security number, Alien Registration number and VA file number if applicable, date and place of birth, current mailing address, phone and fax, and an email address with a box to agree to electronic correspondence from VA.
Items 10 to 12 identify you or your organization. Items 13 to 16 give the name, Social Security number, A-number and VA file number of the person the records are about.
Item 17 lists compensation and pension records such as the claims file (C-File), service treatment records, DD Form 214, C&P exams, pension documents and the OMPF. Item 18 lists other benefit records, from Veteran Readiness and Employment to home loan and life insurance.
Item 19 asks for the VA regional office you are associated with, if known. Item 20 holds remarks, where the form asks for a C&P exam date, the financial records wanted or a life insurance policy number when applicable.
Item 21 explains the three FOIA fee categories, says VA charges $0.15 per single-sided page for photocopying, and asks the amount you are willing to pay and whether you believe you are entitled to a fee waiver or expedited processing.
The requester's certification and signature in ink, marked required, then the third-party and Power of Attorney certifications, each with a signature and date.
The form says to read the Privacy Act and Respondent Burden information on page 4 before completing it.
Use Section I for your own records or Section II for another person's. If completed by hand, the form asks for ink, neat and legible printing and completely filled check boxes.
Check the record types in Section III or Section IV and add any details the form asks for in the Item 20 remarks.
The instructions say a PA request includes your full name, date of birth, place of birth, current mailing address and a handwritten signature, and that a Social Security number or A-number helps VA locate records.
Sign in ink, attach VA Form 21-0845, 21-22 or 21-22a where the form calls for it, then mail or fax it to the Evidence Intake Center or submit the request online.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444. The form says all Privacy Act requests go to the Centralized Support Division at this address.
The form lists Toll-free Fax: (844) 531-7818 and Toll-free Phone: 1-800-827-1000.
VA's form page says you can submit this request online instead of filling out and sending the paper form.
The form points to Ask VA at https://ask.va.gov/ and the toll-free number 1-800-698-2411 (TTY: 711).
The AUG 2023 edition carries OMB Approved No. 2900-0877, with an expiration date of 08/31/2026 and a respondent burden of 5 minutes.
21-0845
57 fields, 3 pages
21-22
63 fields, 4 pages
21-22a
90 fields, 3 pages
20-10207
116 fields, 5 pages
20-10208
77 fields, 2 pages
20-572
37 fields, 1 page
The form says it is signed by the requester, an authorized organization, or a third party the requester has authorized.
No tool matches that search.
The instructions say the form is only used to request military records or a veteran's benefit records. Sections III and IV list types such as the claims file (C-File), DD Form 214, C&P exams, and education, home loan and life insurance benefit records.
The form describes FOIA as the public's right to request access to records from Federal agencies, except those protected by the nine FOIA exemptions. A PA request lets a U.S. citizen or an alien lawfully admitted for permanent residence request access to or amendment of records on themselves.
Yes. VA's form page says you can submit this request online instead of filling out and sending the paper form.
Item 21 says FOIA divides requesters into three fee categories and that VA charges $0.15 per single-sided page for photocopying, with actual costs for a format other than paper copies. It asks the amount you are willing to pay and whether you believe you are entitled to a fee waiver.
The form has signature sections for an authorized third party and for a Power of Attorney. It says a third-party signature needs a valid VA Form 21-0845, and a POA signature a valid VA Form 21-22 or 21-22a, of record or attached.
The form lists Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444, and the toll-free fax (844) 531-7818.
