Items 1 to 4: Veteran and parents
The Veteran's name and VA file number, then each parent's full name, date of birth, Social Security number and the date the parent became financially dependent on the Veteran.
21-509
Statement of Dependency of Parent(s)
- Agency
- VA
- Revision
- May 2024
- Fillable fields
- 132
- Pages
- 4
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 21-509: Statement of Dependency of Parent(s)
VA Form 21-509 is the U.S. Department of Veterans Affairs Statement of Dependency of Parent(s). VA's form page says to use it if you're a Veteran whose parents are dependent on you for support, or you're the parent of a Veteran who died on active duty or as a result of service-connected injuries or disease. The page calls it VA form 21P-509, and the PDF says this edition supersedes VA Form 21P-509, APR 2021.
The PDF has four pages: two pages of instructions, then the statement. It asks about each parent, the parents' net worth, income and expenses, people who depend solely on the parents, and the signatures of the parents and of a Veteran who claims them as dependents.
VA's page says to download the PDF, fill it out and then submit the completed form on that page, or print it and mail it. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form 21-509
Item 5: net worth
Property owned by each parent and a present spouse of a parent, with its description and location, present market value and any encumbrance. The instructions say net worth leaves out the single family dwelling, a reasonable lot area and everyday things like a vehicle, clothing and furniture.
Item 6: income
Each source of income for the parents and a present spouse, with the amount for the latest calendar month and the total for 12 months. The instructions list wages, contributions, Social Security, retirement pay, non-VA pension or insurance, interest, dividends, rents and business or farm income.
Items 7 and 8: expenses
Each type of expense for the last calendar month and for 12 months, such as rent, home repairs, clothing, medical care, utilities, groceries and taxes, and the source that covers expenses that exceed income.
Items 9 and 10: other dependents
Two yes or no questions, 9A for parents and 9B for Veterans, about people in the parents' household who depend solely on the person answering, then each person's name, birth date, relationship to the parents and reason for dependency.
Items 11 to 15: signatures
A certification, then dates, ink signatures, addresses and daytime and evening phone numbers for the mother, the father and the Veteran, and two witness lines for a signature by mark.
How to file VA Form 21-509
- 1
Read and keep the instructions
The form says to read the instructions very carefully, detach them and keep them for your reference.
- 2
Answer every item
Print all answers clearly. The form says to write none or 0 where that is the answer, unknown if you do not know, and to attach a separate sheet for more space, naming the item.
- 3
Report net worth, income and expenses
Use the 12 month period and the calendar month just before the date you complete the form. For a business or farm, the form asks for a separate sheet showing gross income and itemized expenses.
- 4
Sign in ink
Each parent signs and dates the form, and a Veteran claiming the parents as dependents also signs and dates it. A signature by mark needs two witnesses.
- 5
Submit the form
VA's page says you can submit the completed form on that page, or print it and mail it.
Why fill Form 21-509 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 getting help
Online upload
VA's form page says to download the PDF, fill it out and then submit the completed form on that page.
By mail
VA's page says you can print the form and mail it. The PDF names no mailing address; its instructions point to the nearest VA regional office, listed at www.va.gov/directory.
Questions
The instructions list 1-800-827-1000 (Hearing Impaired TDD line 711) and https://www.va.gov/contact-us.
Edition
The May 2024 edition supersedes VA Form 21P-509, APR 2021. It carries OMB Control No. 2900-0089, which expires 05/31/2027, and an estimated burden of 30 minutes.
Related forms
21P-535
Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation When Applicable)
222 fields, 10 pages
21P-0969
Income and Asset Statement for Pension or Parents’ Dependency and Indemnity Compensation (D.I.C.) Claims
428 fields, 11 pages
21P-524
Statement of Person Claiming to Have Stood in Relation of Parent
190 fields, 6 pages
21-686c
Application Request to Add and/or Remove Dependents
625 fields, 15 pages
21-526EZ
Application for Disability Compensation and Related Compensation Benefits
345 fields, 15 pages
Who uses VA Form 21-509?
The instructions say who the form is for and who fills in each part.
Official sources and the blank
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Questions about Form 21-509
Is VA Form 21-509 the same as 21P-509?
VA's form page refers to VA form 21P-509, and the May 2024 PDF says it supersedes VA Form 21P-509, APR 2021. The current PDF is titled VA Form 21-509.
Who counts as a parent on this form?
The form says Parent includes a natural parent, a parent through adoption and a foster parent, including stepparents who stood in the relationship of parent to the veteran.
What does net worth leave out?
The instructions say net worth does not include the parents' single family dwelling unit, a reasonable lot area and personal things used every day like a vehicle, clothing and furniture. For property owned jointly with a spouse, they say to report one-half of the total value for each.
Which period do income and expenses cover?
The form asks for the 12 month period and the calendar month immediately preceding the date the form is completed.
Who signs VA Form 21-509?
The parents sign and date Items 11 and 12 in ink. A veteran claiming the parents as dependents also signs and dates Items 13A and 13B.
How do I send the completed form?
VA's form page says to submit the completed form on that page, or print it and mail it. The instructions point to the nearest VA regional office for questions.