Instructions page
General information on 38 U.S.C. section 5121a, specific instructions for Sections 1 and 2, the mailing address and what to do if you change your mind.
21P-0847
Request for Substitution of Claimant Upon Death of Claimant (VA Form 21P-0847)
- Agency
- VA
- Revision
- November 2024
- Fillable fields
- 35
- Pages
- 2
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 21P-0847: Request for Substitution of Claimant Upon Death of Claimant
VA Form 21P-0847 is the U.S. Department of Veterans Affairs Request for Substitution of Claimant Upon Death of Claimant. VA's form page says to use it if someone you're connected to dies before VA finishes processing their VA claim, decision review, or appeal, and you want to continue their claim.
The instructions cite 38 U.S.C. section 5121a: if a claimant dies while a claim or appeal is pending, a living person who would be eligible to receive accrued benefits due to the claimant under section 5121(a) may, not later than one year after the date of the death of the claimant, request to be substituted as the claimant for the purposes of processing the claim to completion.
The PDF is two pages: an instructions page, then the request in two sections. VA's 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.
What's on VA Form 21P-0847
Section I: identifying information
Items 1 to 5: the deceased claimant's name, the Veteran's file number, Social Security number and date of birth, and the deceased claimant's date of death.
Section II: substitute claimant
Items 6 to 8: the substitute claimant's name, relationship to the deceased and Social Security number.
Items 9 to 12: contact details
Mailing address, daytime, evening and cell phone numbers, an optional email address with a consent note, and a fax number if applicable.
Items 13 and 14: remarks and signature
A remarks space, the signature in Item 14A, which the form says not to print, and the date signed in Item 14B.
How to file VA Form 21P-0847
- 1
Gather the deceased claimant's details
Section I asks for the deceased claimant's name, the Veteran's file and Social Security numbers, the Veteran's date of birth and the date of death.
- 2
Complete Section I
The form says it can be completed online or by hand. By hand, it asks for the information printed in ink, neatly and legibly.
- 3
Complete Section II
Enter your name, relationship to the deceased, Social Security number, address and phone numbers, and an email or fax if you choose.
- 4
Sign and date it
Sign Item 14A and enter the date in Item 14B.
- 5
Keep a copy and send it
The instructions note making a copy of the signed form for your records before mailing it to the Pension Intake Center. VA's page also offers an online request.
Why fill Form 21P-0847 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
By mail
Department of Veterans Affairs, Pension Intake Center, P.O. Box 5365, Janesville, WI 53547-5365.
Online
VA's form page says you can submit your request online instead of filling out and sending the paper form.
Time limit
The instructions quote 38 U.S.C. section 5121a, under which the request is made not later than one year after the date of the death of the claimant.
Revoking the request
The instructions say to write VA a letter to revoke the request if you no longer want to be the substitute.
Edition
The NOV 2024 edition supersedes the DEC 2021 edition. It carries OMB Approved No. 2900-0740, which expires 11/30/2027.
Related forms
21P-534EZ
Application for D.I.C., Survivors Pension, and/or Accrued Benefits
626 fields, 20 pages
21P-601
Application for Accrued Amounts Due a Deceased Beneficiary
107 fields, 5 pages
21P-530EZ
Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (Fillable)
93 fields, 8 pages
21-4138
Statement in Support of Claim (VA Form 21-4138)
33 fields, 2 pages
Who uses VA Form 21P-0847?
VA's form page and the form's instructions describe who files the request.
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Questions about Form 21P-0847
What is VA Form 21P-0847 used for?
VA's form page says to use it if someone you're connected to dies before VA finishes processing their VA claim, decision review, or appeal, and you want to continue their claim.
Is there a time limit for the request?
The instructions quote 38 U.S.C. section 5121a, which says the request is made not later than one year after the date of the death of the claimant.
Can I submit the request online?
Yes. VA's form page says you can submit your request online instead of filling out and sending the paper form.
Where do I mail VA Form 21P-0847?
The instructions list Department of Veterans Affairs, Pension Intake Center, P.O. Box 5365, Janesville, WI 53547-5365.
What if I no longer want to be the substitute?
The instructions say to write VA a letter to revoke your request.
Can I fill out the form by hand?
Yes. The form says it may be completed online or by hand, and by hand the information is printed in ink, neatly and legibly. The signature in Item 14A is marked Do NOT print.