Improved Pension Eligibility Verification Report - Surviving Spouse Without Dependent Children
VA sent you this annual EVR as a surviving spouse receiving Survivors Pension with no dependent children on the award.
Gather before you start
Attach with the form
Section I - Surviving Spouse Identification (pre-printed)
Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII
Pre-printed by VA. Verify all fields are current. Any address change must be reported immediately.
(pre-printed; verify)
- Not reporting address change - future pension mail goes to wrong address.
Section II - Marital Status
Block 6Confirm you have not remarried
IMPORTANT: Remarriage after the veteran's death TERMINATES Survivors Pension immediately. If you have remarried, you must report it and pension payments will stop. If the second marriage ended (divorce, death), contact VA as benefits may be restorable.
e.g., Have not remarried since veteran's death.
- Not reporting a remarriage - VA will eventually discover it through SSA records and will seek recovery of all overpayments with penalties.
Section III - Current Annual Income
Blocks 7-18All income from all sources
Report all of your income: Social Security retirement or disability, any private or civil service pension, wages, interest, dividends, rental income, and any other income. Do not include VA pension payments.
e.g., SSA retirement: $14,400/yr; Interest: $240/yr
- Not reporting SSA COLA increase - report every change.
- Forgetting to update if you started new part-time work.
Section IV - Certification
Blocks 19-20Surviving spouse signature and datePII
Sign and return by the deadline. Missing the deadline suspends your pension.
(signature/date)
- Missing the deadline - contact VA immediately.