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  • Va Form 21-10210. Lay / Witness Statement.

Get Va Form 21-10210. Lay / Witness Statement.

Ead the Privacy Act and Respondent Burden on page 3. Use this form to submit a statement as a veteran/claimant or someone writing on your behalf to support a claim. If you or someone else writing on your behalf are providing additional statement(s) to support your claim(s) please submit this form with your application. For more information, you can contact us through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA forms are available at www.va.gov/vaforms. After.

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How to use or fill out the VA Form 21-10210. Lay / Witness Statement. online

Filling out the VA Form 21-10210, Lay / Witness Statement, is an essential step in supporting a claim for veterans’ benefits. This guide provides clear and supportive instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the VA Form 21-10210 online.

  1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
  2. Begin with Section I, which requires the veteran's identification information. Fill in the veteran's name, social security number, date of birth, VA file number (if applicable), and current mailing address. Make sure to include a valid telephone number and email address where you can receive correspondence.
  3. If the claimant is not the veteran, complete Section II with the claimant's identification information. Provide the claimant's name, social security number, date of birth, VA file number (if applicable), and contact information.
  4. Move to Section III, where you will submit your statement. Clearly describe the facts or circumstances relevant to the claim, indicating the claimed issue you are addressing. Remember to keep your statement concise and focused on your observations or knowledge.
  5. If applicable, fill out Section IV with the witness contact information. Provide the witness's name, their relationship to the veteran or claimant, and their contact information.
  6. Finally, complete Section V by certifying the statement. The necessary signature and date signed are required to finalize the form. Make sure that all information is correct before submission.
  7. Once all sections are complete, you can save the changes, download the form, print it, or share it as needed, ensuring that it is ready for submission to the Department of Veterans Affairs.

Complete your VA Form 21-10210 online today to support your claim effectively.

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A lay statement for the VA should follow this format: It is your opportunity to document all the physical, mental, emotional, personal and social changes you have observed. If you served alongside them and they are using your lay statement to corroborate an in-service stressor, include a detailed account of the event.

VA Form 21-10210, Lay Witness Statement, is comprised of the following five sections: Section I – Veteran's Identification Information. Section II – Claimant's Identification Information. Section III – Statement. Section IV – Witness Contact Information. Section V – Certification of Statement and Signature.

1 For example, a lay witness may testify that a person was drunk if the witness observed how that person was behaving and smelled alcohol on the person's breath. Other examples of a permissible lay opinion would be darkness, speed, age, height, weight, handwriting, voice identification, photo identification.

Before writing a statement, try to: Review your condition. If you are filling out VA Form 21-10210 for yourself, proactively document the approximate cause of your injury and explain how your condition has deteriorated over time. Explain relevant evidence. ... Include examples.

The writer will introduce themselves by providing their name, contact information, and their relationship to the veteran. You should include how frequently you see or speak with the veteran, how long you've known one another, how you met, and any other relevant information about your relationship.

Shows the Impact: Explain how your disability impacts your life beyond just medical symptoms. Discuss day-to-day life, changes in your routines, challenges in physical and mental wellbeing, how it impacts your social relationships, etc. It's important to really emphasize to the VA how your life has been affected.

You can also submit lay evidence to support your claim. Lay evidence is written testimony by you or someone who knows about your condition or related events. Anyone can provide lay evidence. This person doesn't need to have any specific training or education.

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Fill VA Form 21-10210. Lay / Witness Statement.

Use VA Form 2110210 to submit a formal statement to support your VA claimor the claim of another Veteran or eligible family member. Use this form to submit a formal statement to support your VA claim or the claim of another Veteran or eligible family member. 21-10210 or 21-4138 are preferred, but not required. VA Form 21-10210, Lay Witness Statement, can be used to supplement a new benefits claim, an appeal, or a request for a higher disability rating. Below is the quickest way to divide the work on VA Form 2110210 when your buddy is giving the "buddy statement." A buddy statement, also called a "lay witness statement," goes on VA Form 2110210, Statement in Support of Claim. A sworn declaration form is a statement or letter that a layperson writes to support a Veteran's claim. Usually, this person is without medical expertise. VA Form 21-10210 is the latest and greatest form they should use. Keep it brief and to the point, remember BLUF (Bottom Line Up Front).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232