VA Form 21P-0516-1

Improved Pension Eligibility Verification Report - Veteran Without Dependent Children

PensionOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Keeping Your Award Current

Estimated time

20-30 minutes.

When to file

By the deadline printed on the form.

VA sent you this annual EVR as a veteran pension recipient without dependent children on your award.

Gather before you start

—Current income from all sources (SSA, pension, interest, dividends, any wages)

—Current net worth (bank accounts, investments, real estate excluding primary home)

—Any changes to marital status, address, or dependent status

—Medical expenses if claiming deductions

Attach with the form

—Income documentation if amounts changed since last EVR

—21P-8416 Medical Expense Report if claiming deductions

Section I - Veteran Identification (pre-printed)

1 field

Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII

Pre-printed by VA. Verify each field is correct and correct any errors. Address changes are critical - update immediately so future mail reaches you.

Example

(pre-printed; verify)

Common mistakes

Not correcting an out-of-date address - pension mail will go to a wrong address.

Section II - Current Annual Income

1 field · 1 citation

Blocks 6-20All income from all sources for the current year

Report every income source for you and your spouse (if on claim): Social Security, pension, wages, interest, dividends, rental income, annuities, trust income. Do not include VA benefits. If nothing has changed from last year, confirm the prior amounts are still accurate.

Example

e.g., SSA retirement: $16,800/yr; Mil retirement: $9,600/yr; Bank interest: $360/yr

Common mistakes

Not reporting SSA COLA increase from January - every COLA is a reportable income change.
Forgetting to report a new source (inheritance interest, new part-time work).

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section III - Current Net Worth

1 field · 1 citation

Blocks 21-30All assets except primary home and vehicle

Report current balances for checking, savings, CDs, IRAs, brokerage accounts, and any other assets. Current market value of investments, not original cost basis.

Example

e.g., Checking: $4,200; Savings: $22,000; IRA: $45,000; Total: $71,200

Common mistakes

Using original IRA purchase price instead of current market value.
Omitting a CD that recently matured and is now in savings.

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section IV - Certification

1 field

Blocks 31-32Veteran signature and datePII

Sign and return by the deadline. Missing the deadline suspends your pension.

Example

(signature/date)

Common mistakes

Missing the deadline - contact VA immediately and explain if you cannot respond in time.

Statutory & regulatory authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

38 CFR 3.500 - When VA reduces or discontinues benefits.

38 USC 1521 - Wartime non-service-connected pension for low-income veterans.

VA Form 21P-0516-1

Improved Pension Eligibility Verification Report - Veteran Without Dependent Children

PensionOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Keeping Your Award Current

Estimated time

20-30 minutes.

When to file

By the deadline printed on the form.

VA sent you this annual EVR as a veteran pension recipient without dependent children on your award.

Gather before you start

—Current income from all sources (SSA, pension, interest, dividends, any wages)

—Current net worth (bank accounts, investments, real estate excluding primary home)

—Any changes to marital status, address, or dependent status

—Medical expenses if claiming deductions

Attach with the form

—Income documentation if amounts changed since last EVR

—21P-8416 Medical Expense Report if claiming deductions

Section I - Veteran Identification (pre-printed)

1 field

Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII

Pre-printed by VA. Verify each field is correct and correct any errors. Address changes are critical - update immediately so future mail reaches you.

Example

(pre-printed; verify)

Common mistakes

Not correcting an out-of-date address - pension mail will go to a wrong address.

Section II - Current Annual Income

1 field · 1 citation

Blocks 6-20All income from all sources for the current year

Example

e.g., SSA retirement: $16,800/yr; Mil retirement: $9,600/yr; Bank interest: $360/yr

Common mistakes

Not reporting SSA COLA increase from January - every COLA is a reportable income change.
Forgetting to report a new source (inheritance interest, new part-time work).

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section III - Current Net Worth

1 field · 1 citation

Blocks 21-30All assets except primary home and vehicle

Report current balances for checking, savings, CDs, IRAs, brokerage accounts, and any other assets. Current market value of investments, not original cost basis.

Example

e.g., Checking: $4,200; Savings: $22,000; IRA: $45,000; Total: $71,200

Common mistakes

Using original IRA purchase price instead of current market value.
Omitting a CD that recently matured and is now in savings.

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section IV - Certification

1 field

Blocks 31-32Veteran signature and datePII

Sign and return by the deadline. Missing the deadline suspends your pension.

Example

(signature/date)

Common mistakes

Missing the deadline - contact VA immediately and explain if you cannot respond in time.

Statutory & regulatory authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

38 CFR 3.500 - When VA reduces or discontinues benefits.

38 USC 1521 - Wartime non-service-connected pension for low-income veterans.

VA Form 21P-0516-1

Improved Pension Eligibility Verification Report - Veteran Without Dependent Children

PensionOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Keeping Your Award Current

Estimated time

20-30 minutes.

When to file

By the deadline printed on the form.

VA sent you this annual EVR as a veteran pension recipient without dependent children on your award.

Gather before you start

—Current income from all sources (SSA, pension, interest, dividends, any wages)

—Current net worth (bank accounts, investments, real estate excluding primary home)

—Any changes to marital status, address, or dependent status

—Medical expenses if claiming deductions

Attach with the form

—Income documentation if amounts changed since last EVR

—21P-8416 Medical Expense Report if claiming deductions

Section I - Veteran Identification (pre-printed)

1 field

Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII

Pre-printed by VA. Verify each field is correct and correct any errors. Address changes are critical - update immediately so future mail reaches you.

Example

(pre-printed; verify)

Common mistakes

Not correcting an out-of-date address - pension mail will go to a wrong address.

Section II - Current Annual Income

1 field · 1 citation

Blocks 6-20All income from all sources for the current year

Example

e.g., SSA retirement: $16,800/yr; Mil retirement: $9,600/yr; Bank interest: $360/yr

Common mistakes

Not reporting SSA COLA increase from January - every COLA is a reportable income change.
Forgetting to report a new source (inheritance interest, new part-time work).

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section III - Current Net Worth

1 field · 1 citation

Blocks 21-30All assets except primary home and vehicle

Report current balances for checking, savings, CDs, IRAs, brokerage accounts, and any other assets. Current market value of investments, not original cost basis.

Example

e.g., Checking: $4,200; Savings: $22,000; IRA: $45,000; Total: $71,200

Common mistakes

Using original IRA purchase price instead of current market value.
Omitting a CD that recently matured and is now in savings.

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section IV - Certification

1 field

Blocks 31-32Veteran signature and datePII

Sign and return by the deadline. Missing the deadline suspends your pension.

Example

(signature/date)

Common mistakes

Missing the deadline - contact VA immediately and explain if you cannot respond in time.

Statutory & regulatory authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

38 CFR 3.500 - When VA reduces or discontinues benefits.

38 USC 1521 - Wartime non-service-connected pension for low-income veterans.

VA Form 21P-0516-1

Improved Pension Eligibility Verification Report - Veteran Without Dependent Children

PensionOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Keeping Your Award Current

Estimated time

20-30 minutes.

When to file

By the deadline printed on the form.

VA sent you this annual EVR as a veteran pension recipient without dependent children on your award.

Gather before you start

—Current income from all sources (SSA, pension, interest, dividends, any wages)

—Current net worth (bank accounts, investments, real estate excluding primary home)

—Any changes to marital status, address, or dependent status

—Medical expenses if claiming deductions

Attach with the form

—Income documentation if amounts changed since last EVR

—21P-8416 Medical Expense Report if claiming deductions

Section I - Veteran Identification (pre-printed)

1 field

Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII

Pre-printed by VA. Verify each field is correct and correct any errors. Address changes are critical - update immediately so future mail reaches you.

Example

(pre-printed; verify)

Common mistakes

Not correcting an out-of-date address - pension mail will go to a wrong address.

Section II - Current Annual Income

1 field · 1 citation

Blocks 6-20All income from all sources for the current year

Example

e.g., SSA retirement: $16,800/yr; Mil retirement: $9,600/yr; Bank interest: $360/yr

Common mistakes

Not reporting SSA COLA increase from January - every COLA is a reportable income change.
Forgetting to report a new source (inheritance interest, new part-time work).

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section III - Current Net Worth

1 field · 1 citation

Blocks 21-30All assets except primary home and vehicle

Report current balances for checking, savings, CDs, IRAs, brokerage accounts, and any other assets. Current market value of investments, not original cost basis.

Example

e.g., Checking: $4,200; Savings: $22,000; IRA: $45,000; Total: $71,200

Common mistakes

Using original IRA purchase price instead of current market value.
Omitting a CD that recently matured and is now in savings.

Authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

Section IV - Certification

1 field

Blocks 31-32Veteran signature and datePII

Sign and return by the deadline. Missing the deadline suspends your pension.

Example

(signature/date)

Common mistakes

Missing the deadline - contact VA immediately and explain if you cannot respond in time.

Statutory & regulatory authority

38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.

38 CFR 3.500 - When VA reduces or discontinues benefits.

38 USC 1521 - Wartime non-service-connected pension for low-income veterans.