VA Form 21-0845: Authorization to Disclose Personal Information to a Third Party

What VA Form 21-0845 is for

Use this form to let VA share your benefit or claim information with one person or one organization you choose. It cannot be used to share federal tax information, and VA keeps only one 21-0845 on file at a time. The form says a beneficiary recognized as incompetent for VA purposes may not sign it.

Want someone to represent you in your claim, not only receive information? That takes an appointment: Form 21-22 for an organization, or 21-22a for an individual. Appoint a representative instead.

What you fill in by hand

The filler never asks for your Social Security number, VA file number, date of birth or signature. You write those in by hand. Leave these boxes for yourself:

• Item 2: veteran's Social Security number (and the copy at the top of page 3)
• Item 3: VA file number
• Item 4: veteran's date of birth
• Item 5: veteran's service number
• Item 8: international phone number
• Item 14B: the answer to your security question
• Items 15 and 16: signature and date

Where to send it

• Make a copy of your signed form before you send it. VA keeps only one 21-0845 on file at a time.
• Online: use the authorization tool linked from VA's 21-0845 page, or upload the signed form through Direct Upload at access.va.gov.
• By mail: Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.
• Changing your mind: tell VA in writing, call 1-800-827-1000, or use Ask VA at ask.va.gov. VA cannot take back information it already gave out.

Claim Raven does not submit forms to VA. You review the filled PDF, sign and date it, and send it to VA yourself. Claim Raven is independent and is not affiliated with VA.

Official form and guide

• VA's page for Form 21-0845 on VA.gov
• VA Form 21-0845 example and how to fill it out

This filler uses the May 2026 edition of the form.