VA Form 21-0966Verified official record

Intent to file

Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC

Notifies VA that you plan to file certain claims and may preserve a potential effective date while you prepare.

When it may apply

Purpose and use

Use before a complete claim when you need more time and the intended benefit accepts an intent to file.

When not to use it

An intent to file is not a completed claim and does not replace the benefit application.

Responsibility

Who completes and signs it?

Completed by
veteran or claimant
Signed by
veteran or claimant
Availability
online and pdf
Submission
follow current form instructions
Always start with the official page

Open the current VA version.

Check the revision, instructions, signature requirements, and delivery options immediately before use.

Read before use

Important limitations

  • Verify the current revision and submission instructions on the official VA page before signing or sending the form.
  • This planner identifies forms that may fit a situation; it does not determine eligibility or filing strategy.

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