VA Form 21-4138 Online
Use this online workflow when you need to add a written statement or clarification to a VA benefits claim. Complete the form, review the generated PDF, and continue to mailing.
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Need more context?
The form is ready to fill now. If you want supporting instructions, mailing notes, or source links, they are below.
What you need+
- Veteran or beneficiary identifying information
- Current mailing address
- A clear written statement supporting the claim
- Signature and date
- Signed form (wet signature required)
- Supporting evidence (optional) (optional) — Attach records or documents that support the statement, such as medical records, correspondence, or lay statements.
How it works+
- Fill out the form
- Add attachments
- Preview the PDF
- Mail it
Where it gets mailed+
We prefill the recipient for you.
Packet order+
- Cover sheet (auto-generated)
- Completed form PDF
- Attachments (in the order you upload)
Common mistakes+
- Leaving the remarks section too vague to help the claim reviewer.
- Forgetting to sign and date page 2.
- Using an outdated mailing address for the VA Evidence Intake Center.
- Omitting claimant identification details that tie the statement to the VA file.
FAQs+
When should I use VA Form 21-4138?
Use VA Form 21-4138 when you need to submit a written statement, clarification, or explanation in support of a VA benefits claim.
Do I need to sign VA Form 21-4138?
Yes. The form requires the veteran or beneficiary to sign and date the declaration section on page 2.
Can I attach supporting evidence with this form?
Yes. If your statement refers to medical records, correspondence, buddy statements, or other evidence, include those attachments with your mailing.
Related+
Last verified+
Last Department of Veterans Affairs verification: March 27, 2026