Application for Restored Entitlement Program for Survivors (REPS)
You (or your child) were receiving SSA student or other dependency benefits that were eliminated in 1981 following the veteran's death on active duty or from a service-connected condition.
Gather before you start
Attach with the form
Section I - Claimant Identification
Blocks 1-5Surviving spouse or child name, SSN, addressPII
Your identifying information. REPS provides benefits to eligible surviving spouses and children of veterans who died on active duty or from a service-connected condition when their SSA benefits were terminated in 1981.
(your legal name, SSN, address)
- Filing without first confirming eligibility with a VSO - this benefit has a very narrow eligible population.
Section II - Veteran Information
Blocks 6-10Veteran name, date of death, cause of death (active duty or SC)PII
The veteran must have died on active duty OR from a service-connected condition. Include the date, place, and cause of death.
(veteran's name, date of death, cause)
- Assuming eligibility without checking - veterans who died from non-service-connected conditions do not qualify.
Section III - Prior SSA Benefits
Blocks 11-15SSA benefits you received and when they were terminated
Describe the SSA benefits you (or your child) received before the 1981 elimination. Include SSA award dates, benefit type, and when SSA terminated the benefits due to the legislative change.
e.g., SSA dependency benefits received 1976-1981; terminated August 1981 per Pub. L. 97-35.
- No documentation of prior SSA benefits - VA needs this to verify REPS eligibility.
Section IV - Certification
Blocks 16-17Claimant signature and datePII
Sign and date under penalty of perjury.
(signature/date)
- Filing without consulting a VSO about eligibility.