21-686c
Application Request to Add and/or Remove Dependents
VA Form 21-686c is the U.S. Department of Veterans Affairs Application Request to Add and/or Remove Dependents. VA's form page says to use it to submit a claim for additional benefits for a dependent, or to request to remove a dependent from your benefits. The PDF opens with a six-page notice about the information and evidence VA may ask for, followed by the application and an addendum page for more children.
The notice lists three kinds of beneficiaries who may be entitled to additional benefits for dependents: a Veteran receiving disability compensation with a combined disability rating of at least 30 percent, a Veteran receiving Veterans Pension, and a surviving spouse receiving survivors benefits. It also names other forms some situations call for, such as VA Form 21-674 for a child aged 18 to 23 who is in school.
VA's page says you can submit the request online instead of filling out and sending the paper form. You can fill out the PDF free in your browser on this page and download the result without an account.
Veteran's name, Social Security number, VA file number, date of birth and service number, the claimant's name and SSN if other than the Veteran, phone, email and mailing address. The form marks this section as required.
Spouse's legal name, date of birth, SSN, date and place of marriage, and how you were married: civil, religious, tribal, proxy, common law or other. It asks whether the spouse is also a Veteran and whether you live together. Items 14 and 15 list prior marriages for both of you.
Up to four children, each with SSN, date and place of birth, who the child lives with if not the claimant, and status: biological, adopted, stepchild, 18 to 23 and in school, permanently incapable of self-support, or previously married.
The former spouse's name and the date and place of divorce, then any stepchildren of that former spouse, whether you still support them, where they live, the date they left the household and the share of support provided.
The death of a dependent with the dependent type, date and place of death, the name of a child who married and the date, and the date a schoolchild over 18 stopped attending school.
Remarks in Item 25, the certification and signature in Items 26A and 26B, which the form marks as required, and a Section XI addendum page for children beyond the fourth.
The table of contents on page 1 maps each situation, such as adding a spouse, adding a child or reporting a divorce, to its instruction pages and its application pages.
The notice lists extra forms for some cases, such as VA Form 21-674 for a child 18 to 23 in school, VA Form 21-2680 or VA Form 21-0779 for spousal aid and attendance, and VA Form 21-4170 with VA Form 21P-4171 for a common-law marriage.
The form asks for the SSN of each dependent unless one has not been assigned, with the reason given in Item 25. The notice lists when VA may ask for evidence such as a marriage record or a birth certificate.
The form says Sections I and X are required, and the other sections are completed only for the changes being reported. The page 15 addendum is for a fifth child or more.
The form says the Veteran signs unless the claimant is the surviving spouse or a designated alternate signer. The certification notes that signing permits benefit payment changes that could create an overpayment.
The form lists the Evidence Intake Center in Janesville, Wisconsin, for mail, and va.gov or Direct Upload through access.va.gov to submit 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.
VA's form page says you can submit the request online. The form says signing in at va.gov lets VA prefill parts of the application and save work in progress, and it also lists Direct Upload via access.va.gov.
VA's page says VA automatically removes children from benefits when they turn 18. For a child who stays in school past 18, the page says to submit the child's information again, using VA Form 21-674.
The form says its primary purpose is to gather information that may result in a change to VA benefits, and that VA sends additional notice about repayment options if an overpayment results.
The form points to accredited veterans service officers at va.gov/vso, VA's contact page at va.gov/contact-us and the toll-free number 1-800-827-1000 (TDD relay: 711).
21-674
107 fields, 3 pages
21-509
132 fields, 4 pages
21-526EZ
345 fields, 15 pages
21-2680
112 fields, 4 pages
21-4170
171 fields, 5 pages
21P-4171
108 fields, 2 pages
The notice at the front of the form describes these beneficiaries and changes.
No tool matches that search.
Yes. VA's form page says you can submit your request online instead of filling out and sending the paper form. You can also fill out the PDF here free and print or download it.
The form says Section I, the identification information, and Section X, the certification and signature, are required to process the request. The other sections are completed only for the changes that apply.
The form says to submit VA Form 21-674, Request for Approval of School Attendance, and to send VA Form 21-686c with it only if you have never received additional benefits for that child. VA's page says the online VA Form 21-686c includes VA Form 21-674 when that option is picked in the first question.
The form says there is no need to submit VA Form 21-686c when claiming additional benefits for a dependent parent. It names VA Form 21P-509, Statement of Dependency of Parent(s), which VA's page lists as VA Form 21-509.
Section XI, the addendum on page 15, adds more children. The form says to make additional copies of that page if more space is needed.
The form asks for the SSN of each dependent unless one has not been assigned, and says to explain why in Section IX, Item 25, Remarks.
The notice says Veterans receiving disability compensation are not required to report a separation or estrangement from a spouse, as it has no effect on the award. VA removes a spouse after a death, divorce or annulment.
The form lists Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.
