Items 1 to 4: the insured
Name and address of the insured, the insurance policy number, the Social Security number, which the form marks Must Supply, and a daytime telephone number.
29-0165
VA Matic Enrollment/Change
- Agency
- VA
- Revision
- March 2026
- Fillable fields
- 12
- Pages
- 1
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 29-0165: VA Matic Enrollment/Change (Pre-Authorized Collections)
VA Form 29-0165 is the U.S. Department of Veterans Affairs VA Matic Enrollment/Change form. The PDF itself is titled Pre-Authorized Collections (PAC) Enrollment/Change. The form says it can be used to enroll in pre-authorized deductions from a checking account for the payment of premiums, or to make a change to an existing deduction. VA's page lists it under life insurance.
The form is one page. Section I is completed by the insured or an authorized agent and holds the authorization for VA to start or change a deduction for Government Life Insurance premiums. Section II holds the bank details, with a sample check showing where the routing and account numbers appear. 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 29-0165
The authorization
A statement authorizing VA to start or change a deduction from the account for Government Life Insurance premiums and to adjust it if premiums increase or decrease. It says each deduction is the monthly premium amount, made on the premium due date.
Items 5 and 6: signature
The signature of the insured or authorized agent, in ink, and the date signed.
Section II: premium payment information
Items 7 to 10 ask for the name of the bank or financial institution, the names listed on the account, the 9-digit routing number and the checking account number.
Sample check
Shows that the routing number is always 9 digits and that the account number varies in length and may contain dashes or spaces.
How to file VA Form 29-0165
- 1
Fill in Items 1 to 4
Enter the insured's name and address, the policy number, the Social Security number and a daytime phone number.
- 2
Add the bank details
Enter the bank name, the names on the account, the 9-digit routing number and the checking account number. The sample check shows where each number appears.
- 3
Answer Item 11
Check Yes or No for also using the account for direct deposit for the policy or policies.
- 4
Sign and date in ink
The insured or authorized agent signs Item 5 in ink and enters the date in Item 6.
- 5
Upload or mail it
The form says it may be submitted online through VA's secure upload website or by mail to the VA Insurance Center in Janesville, Wisconsin.
Why fill Form 29-0165 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
Online
Upload the form using VA's secure website at https://insurance.va.gov/home/IDU.
By mail
Department of Veterans Affairs, Insurance Center, PO Box 5209, Janesville, WI 53547-5209.
Questions
The form lists the toll-free number 1-800-669-8477 for questions about your insurance.
Edition
The March 2026 edition supersedes the February 2023 edition, which will not be used. It carries OMB Control No. 2900-0525, which expires 03/31/2029, and an estimated burden of 15 minutes.
Related forms
Who completes VA Form 29-0165?
The form says Section I is completed by the insured or an authorized agent.
Official sources and the blank
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Questions about Form 29-0165
What is VA Form 29-0165 used for?
The form says it can be used to enroll in pre-authorized deductions from a checking account for the payment of premiums, or to make a change to an existing deduction.
Is VA Matic the same as Pre-Authorized Collections?
VA's page names VA Form 29-0165 VA Matic Enrollment/Change, and the PDF of the same form is titled Pre-Authorized Collections (PAC) Enrollment/Change.
How much is each deduction?
The authorization says each deduction will be in the amount of the monthly premium payment and is made on the premium due date. It also authorizes VA to adjust the amount if premiums increase or decrease.
Which policies does the change cover?
Item 2 says the change applies to all active premium paying policies except those that are paid-up or on waiver. The authorization covers all Government Life Insurance policies the insured owns unless the insured specifies otherwise.
Can an authorized agent complete the form?
Yes. Section I is completed by the insured or an authorized agent. The form asks an agent to send a copy of their authorization, such as a power of attorney, if not already provided.
How do I send VA Form 29-0165?
The form says to upload it at https://insurance.va.gov/home/IDU or mail it to Department of Veterans Affairs, Insurance Center, PO Box 5209, Janesville, WI 53547-5209.