Section I: Veteran's information
Items 1 to 9: the Veteran's name, Social Security number, VA file number, date of birth, service number, insurance numbers, mailing address, phone and an optional email.
21-22
Appointment of Veterans Service Organization as Claimant’s Representative
- Agency
- VA
- Revision
- July 2023
- Fillable fields
- 63
- Pages
- 4
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 21-22: Appointment of Veterans Service Organization as Claimant's Representative
VA Form 21-22 is the U.S. Department of Veterans Affairs (VA) form for appointing a Veterans Service Organization (VSO) as a claimant's representative. VA's page says to use it when you want a VSO to help you with VA benefits or claims. The form says the appointment covers the whole organization named on it, not only the person who signs for that organization.
The form asks for the Veteran's information, the claimant's information if the claimant is someone other than the Veteran, the organization and its official representative, optional authorizations for protected records and address changes, and signatures from both the claimant and the representative. To have an individual help instead of an organization, VA points to VA Form 21-22a.
VA estimates the form takes about 5 minutes. You can fill it out free in your browser on this page and download the result without an account.
What's on VA Form 21-22
Section II: claimant's information
Items 10 to 14, only if the claimant is someone other than the Veteran: name, date of birth, relationship to the Veteran, mailing address, phone and optional email.
Section III: service organization
Item 15 names an organization recognized by VA, chosen from the list on page 3. Items 16A to 18 give the official representative's name and job title, the organization's email and the date of the appointment.
Items 19 and 20: protected records
A checkbox authorizing VA to disclose records about treatment for drug abuse, alcoholism or alcohol abuse, HIV infection or sickle cell anemia, with Item 20 for any of those conditions to exclude.
Item 21: address changes
A checkbox authorizing any official representative of the organization to change the claimant's address in VA records.
Section V: signatures
Items 22A and 22B for the Veteran or claimant's signature and date, and 23A and 23B for the organization representative's. The form says it does not need a notary.
How to appoint a VSO with VA Form 21-22
- 1
Check the organization's recognition
Page 3 lists the organizations and state agencies VA recognizes. The form recommends confirming accreditation on the VA Office of General Counsel list at va.gov/ogc/apps/accreditation before signing any contract or appointing someone.
- 2
Fill in the Veteran and claimant details
Complete Section I, and Section II only if the claimant is not the Veteran. If you fill it out by hand, the form asks for neat, legible print in ink.
- 3
Name the organization
Enter the organization in Item 15 and its official representative in Items 16A and 16B. The form says this appoints the entire organization, not only that person.
- 4
Choose the optional authorizations
Items 19 to 21 are checkboxes for access to protected treatment records, exceptions to that access, and address changes. Items 19 and 21 apply only when their box is checked.
- 5
Sign with the representative
The Veteran or claimant signs and dates Items 22A and 22B, and the organization's representative signs and dates Items 23A and 23B.
- 6
Send it to VA
The form says documents can be sent by mail, in person at a VA regional office, or electronically, and that VA recommends electronic submission as the fastest. Page 4 lists the mailing addresses.
Why fill Form 21-22 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
Where to send it and what to know
Online
VA's page says you can fill out the form online instead of on paper. The form also names Direct Upload at access.va.gov for sending correspondence electronically.
By mail
Page 4 lists addresses by claim type: compensation claims to the Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444, and pension and survivors benefit claims to the Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365. It also lists Fiduciary and Board of Veterans' Appeals addresses.
Fees
The form says the appointed representative will not charge any fee or compensation for service under this appointment.
How long it lasts
The form says the organization is recognized as the sole representative while the appointment is in effect, and the organization may revoke the appointment at any time, subject to 38 CFR 20.6. The Item 19 and 21 authorizations end on a written revocation filed with VA or the appointment of another representative.
Help and time
The form lists Ask VA at ask.va.gov and 1-800-827-1000 (TTY: 711). VA estimates 5 minutes to complete it. OMB Control No. 2900-0321.
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Who uses VA Form 21-22?
The form is signed by the Veteran or claimant who appoints the organization, and by the organization's official representative.
Official sources and the blank
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Questions about Form 21-22
Does a VSO charge a fee under VA Form 21-22?
The form says the appointed representative will not charge any fee or compensation for service rendered under this appointment.
Do I have to be a member of the organization?
No. Page 3 of the form says membership in an organization is not a prerequisite to appointing it as the claimant's representative.
Does VA Form 21-22 need to be notarized?
No. The form says this power of attorney does not require execution before a notary public.
What if I want an individual to represent me instead?
VA's page points to VA Form 21-22a, Appointment of Individual as Claimant's Representative. The person you want to help you completes and submits that form.
Does the form appoint only the person named in Item 16A?
No. The form says naming an official representative in Item 16A is an appointment of the entire organization, not of that individual alone.
Can I have more than one VSO at a time?
The form says that while the appointment is in effect, the organization named is recognized as the sole representative for your claim before VA.
Where can I find recognized organizations?
Page 3 lists recognized national, regional and local organizations and the state veterans service agencies. The VA Office of General Counsel list can be searched by name, state or ZIP code.