Improved Pension Eligibility Verification Report - Veteran With Dependent Children
VA sent you this annual EVR as a veteran pension recipient with dependent children listed on your award.
Gather before you start
Attach with the form
Section I - Veteran Identification (pre-printed)
Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII
Pre-printed by VA. Verify accuracy, especially address. Corrections should be noted clearly.
(pre-printed; verify)
- Not updating a changed address - pension mail sent to wrong address.
Section II - Current Annual Income
Blocks 6-20All income for household (veteran, spouse, dependent children)
Report all income for you, your spouse, and dependent children. Children's SSA survivors benefits, wages, and other income must be included unless you have filed for exclusion (21P-0571).
e.g., Veteran SSA: $16,800/yr; Child SSA survivors: $3,840/yr
- Not reporting children's Social Security survivors benefits - these are income unless excluded.
Section III - Dependent Children Status
Blocks 21-32Current status of each dependent childRepeatable
For each child on your award: confirm they are still living, confirm their current age, and confirm whether they are in school (if 18-23). Report any child who has turned 18 and is not in school, or who has turned 23 and aged off, or who has married, or who has died.
e.g., Emily Smith (DOB 06/15/2010) - living, age 15, at home. Timothy Smith (DOB 03/22/2004, age 22) - enrolled full time at ASU.
- Not reporting that a child turned 18 and left school - dependency ends and pension is adjusted.
- Not filing 21-674 separately for school approval when a child is 18-23 in school.
Section IV - Certification
Blocks 33-34Veteran signature and datePII
Sign and return by the deadline. Missing the deadline suspends your pension.
(signature/date)
- Missing the deadline.