VA Form 21P-534EZ lets an eligible surviving spouse or child apply for Dependency and Indemnity Compensation (DIC), Survivors Pension, and accrued benefits. Those are different benefits on one application. Item 2I is where you identify which ones you are claiming.

The current VA form page links to the August 2025 edition, replacing July 2022. I checked the full 20-page package on September 25, 2026. The application starts on page 10, after nine pages of instructions, explanations, and a checklist. Care-expense worksheets follow on pages 19 and 20.

Choose the benefit before filling every section

DIC is a survivor benefit connected to a qualifying service-related death or certain other qualifying circumstances, including specified periods of total disability before death. The veteran did not necessarily have to win a service-connection claim during life. See VA's DIC eligibility guidance.

Survivors Pension is an income- and asset-based benefit for eligible survivors of veterans with qualifying wartime service. Financial reporting is central to that claim.

Accrued benefits are benefits due but unpaid before death. A pending claim or appeal also raises the separate question of substitution, which can allow an eligible survivor to continue it and submit evidence. VA's accrued benefits and substitution factsheet explains that distinction. Generally, an accrued-benefits claim must reach VA within one year of death; a substitution request also has a one-year deadline after the original claimant's death. Do not assume preparing this application gives you extra time to request substitution.

Parents seeking Parents' DIC use 21P-535. Someone seeking reimbursement from accrued benefits for last-illness or burial expenses may need 21P-601. Follow the form matching your relationship and request.

Sections I and II: Veteran and claimant, Items 1 and 2

In the official PDF, 1A through 1H collect the veteran's name, Social Security number, birth date, prior VA-claim history, file number, whether death occurred on active duty, service number, and death date.

2A through 2H collect your name, relationship to the veteran, Social Security number, birth date, whether you are a veteran, mailing address, telephone number, and optional email. The relationship choices include surviving spouse, a schoolchild age 18 to 23, a custodian applying for a child under 18, and a disabled adult child.

2I: Check every benefit you are claiming. Do not treat the three boxes as interchangeable. Your choices determine which later questions apply.

Gather the death certificate, service documents, relevant marriage records, and evidence supporting the benefit requested. Page 9 provides a checklist. Send copies rather than original documents, as the instructions warn that originals will not be returned.

Section III: Service history, Items 3A to 3M

The heading allows you to skip this section if the veteran was receiving VA compensation or pension at death. Otherwise:

  • 3A: Other names used during service.
  • 3B and 3C: Active-duty entry and release dates.
  • 3D and 3E: Branch and place of last separation.
  • 3F and 3G: Federal activation under Title 10 for National Guard service and activation date.
  • 3H through 3J: Reserve or Guard unit name, address, and telephone number, following the printed skip instructions.
  • 3K through 3M: Prisoner-of-war status and confinement dates when applicable.

Use service records to distinguish active service from other membership or training periods. The evidence instructions discuss DD214 copies and missing service records; a guessed service date does not resolve an absent record.

Sections IV and V: Marriage history, Items 4 through 6

Section IV applies to surviving-spouse claims. Other claimants skip to Section VI.

4A asks about any known reason the marriage might not have been legally valid. 4B and 4C address whether you were married at death and how the marriage ended if not. 4D through 4H ask for its beginning and ending dates, places, and type.

4I and 4J ask about a child born to you and the veteran and an expected birth. 4K through 4M cover continuous cohabitation and any separation. Explain the actual reason, dates, and duration where requested; living apart is a fact to report, not a reason to rewrite the marriage history.

4N through 4Q address remarriage after the veteran's death, its dates, and how it ended or whether it continues. 4R asks about additional later marriages and directs you to 21-4138 for the details.

Section V begins with 5A: If VA already recognized you as the spouse, or you and the veteran were only ever married to each other, follow the instruction to skip to Section VI. Otherwise, 5B through 5M cover two prior marriages of the veteran; 5N asks about more. 5O through 5Z cover your marriages before marrying the veteran. Item 6 asks whether you have more to report. The form identifies 21-686c or 21-4138 for overflow marriage history.

Section VI: Children, Items 6A to 6S

6A is the number of dependent children. Three child entries use 6B through 6F, 6G through 6K, and 6L through 6P. Each asks for name, birth date, Social Security number, birthplace, and applicable status. Report support where requested for a child living elsewhere.

6Q asks whether children who live away share an address. 6R and 6S identify the custodian and address. If they have different arrangements, the form directs you to explain the custodians and addresses on 21-4138. Use 21-686c if more child entries are needed.

Attach 21-674 for qualifying school attendance, adoption evidence when applicable, and relevant disability evidence for a child whose incapacity began before 18. The instructions say a child over 18 seeking DIC needs their own application.

Sections VII and VIII: DIC and additional care needs

7A: Select the applicable DIC basis: DIC, a claim under 38 U.S.C. 1151, or reevaluation of a previously denied claim under the PACT Act option. These choices are not interchangeable. The instructions explain the particular evidence for each.

7B: Identify VA medical centers with relevant treatment and the dates. Private records are addressed in the evidence instructions, not by pretending a private clinic is a VA facility.

8A: Report whether you seek increased survivor benefits because you need regular assistance, have severe visual impairment, or are generally confined to your immediate premises. A yes calls for 21-2680, completed by an eligible medical examiner.

8B: Report nursing-home residence. A yes calls for 21-0779, the nursing-home information form.

Section IX: Pension income and assets, Items 9A to 9L

This is the financial section for Survivors Pension. The heading directs a non-pension claimant claiming last expenses onward to Section X.

  • 9A: Assets over $75,000, excluding the primary residence. A yes requires 21P-0969; a no calls for an estimate. $75,000 is a reporting trigger, not the pension net-worth limit.
  • 9B: Asset transfers in the three calendar years before this year. A yes calls for 21P-0969.
  • 9C through 9F: Home ownership, lot size over two acres, value of excess land, and whether that land is marketable. Follow the skip instructions and additional-form direction.
  • 9G: Number of income sources. Five or more calls for 21P-0969.
  • 9H: Non-Social-Security income received last year that is no longer received. A yes calls for 21P-0969.
  • 9I through 9L: Income recipient, type, payer, and current gross monthly amount for each source.

If earlier answers require 21P-0969, the form says to put only Social Security income in 9I through 9L and report other income on 21P-0969. Avoid reporting the same income twice. Use gross income, before deductions, rather than the bank deposit after deductions.

Section X: Expenses, Items 10A to 10J

10A asks whether you claim unreimbursed medical or other expenses. If no, go to Section XI.

10B, 10C, and 10D each provide a care-provider entry. Their numbered fields identify whose care was paid, the provider, care type, hourly rate and monthly hours for in-home care, service dates, payment frequency, and amount paid.

10E through 10J cover other medical, last-illness, and burial expenses. Each entry identifies whose expense it was, whom you paid, its purpose, payment date, frequency, and amount. Do not include amounts paid by insurance or another family member. Use 21P-8416 for additional space.

For care expenses, have the provider complete the applicable worksheet for each provider:

  • Page 19, residential or adult-daycare worksheet: Items 1 through 7 identify the recipient, provider, role, and facility contacts; 8 through 10 cover activities, licensing and care; 11 through 14 cover dates and charges; 15 and 16 are the provider signature and date.
  • Page 20, in-home attendant worksheet: Items 1 through 7 identify the recipient, provider, licensing, agency, and address; 8 through 10 describe assistance and the primary care role; 11 through 15 cover dates, charges, and hours; 16 and 17 are the provider signature and date.

Listing an expense does not establish that every dollar is deductible. These worksheets give VA information to evaluate it.

Sections XI through XIV: Payment details and signatures

11A through 11C: Financial institution, routing number, account type and number. Follow the instruction for an existing VA direct-deposit arrangement or no bank account. Do not assume the veteran's former deposit instructions automatically become yours.

12A and 12B: Claimant's signature or mark and signing date, after reading the certification that begins on page 17.

13A through 13F: Two witnesses' signatures, names, and addresses only when the claimant signs with an X.

14A and 14B: Alternate-signer signature and date when the printed certification applies. Read its authority and claimant-condition requirements. A family relationship alone does not explain every required condition.

Fictional example: A surviving spouse seeking DIC

This is an invented application outline with no real person or account information. Assume the veteran died on August 3, 2026, the claimant is the surviving spouse, and the claimant seeks DIC based on a service-connected condition identified as a cause of death.

The spouse enters 08/03/2026 in 1H, selects surviving spouse in 2B, and DIC in 2I. The marriage history uses actual records in a real application. 7A selects DIC; 7B identifies relevant VA treatment. The death certificate and relevant supporting records accompany the request.

The example does not seek Survivors Pension or care-related increases, so it does not invent financial or examiner findings to fill those sections. The spouse completes the applicable payment information and signs 12A and 12B. These entries illustrate routing through the form; they do not establish an award.

Submission, timing, and what follows

Online: Use the application linked from VA's 21P-534EZ page, or upload the completed paper application through AccessVA QuickSubmit.

Mail: Department of Veterans Affairs, Pension Intake Center, P.O. Box 5365, Janesville, WI 53547-5365.

Fax: The 534EZ does not print a fax line. VA's intake directory lists 844-655-1604 for pension and survivors. This is a general intake number. Confirm routing with VA at 800-827-1000 if your correspondence gives different instructions.

Filing timing can affect the start date of survivor benefits. Accrued-benefit and substitution deadlines need separate attention. If you are preparing a DIC or pension application, the instructions identify 21-0966, an intent to file, as a way to protect a potential claim date while completing the application within one year. After submitting an intent to file to VA, Claim Raven's intent-to-file tracker can record its date and calendar anniversary in your browser. It does not notify VA or send reminders.

Keep your submission confirmation. VA may request missing evidence, obtain records, or seek a medical opinion before deciding. Missing signatures, unexplained marriage dates, duplicate income, and unsigned care worksheets leave specific questions unanswered. Address those before filing, and respond to later VA requests using their stated deadlines.

Sources and scope

Verified September 25, 2026: the August 2025 21P-534EZ package, VA's form and DIC pages, the accrued-benefits factsheet, and the intake directory linked above. This is a form walkthrough, not a calculation of eligibility or payment. The example is fictional.

Where to go next

Disclaimer

I'm Landon, founder of Claim Raven and a U.S. Army veteran, not a lawyer, VSO, or VA-accredited representative. Claim Raven is data analysis, not legal, medical, or VA-accredited advice. An accredited representative can help with survivor eligibility, filing deadlines, and substitution.