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Please Read Before You Start What Is Va Form 10-10Ez Used For?: What You Should Know
VA Form 10-10EZ Step 3: Filling Out Fill out the first page of this form in black and white with your name, date of birth, and the branch of service. Make sure to write your first and last name when completing the form. Do you have a disability? This is called service-connected disability: Have you been discharged from the Armed Forces? Please see Question 17 of Form 10-10EZ. VA Form 10-10EZ-A. If you are currently receiving treatment under another Veteran's medical program, use the form available on . Step 4: Fill Out VA Form 10-10EZ-A. What's the “other information” field? You can request one copy of your Veteran's Record, a copy of the Certificate of Eligibility, or your DD-214. The Veterans' Record shows your VA number to the Social Security Administration and information about your discharge, discharge status and dates of discharge. Use the Request for Copy of Record, Certificate of Eligibility, and DD-214 forms and pay the fee required. Veterans' Record Request (for copies on paper) (PDF 10.3 KB) Veterans' Record Request (for forms on the computer) (PDF 8.2 KB) (Please refer prior correspondence if your request is for a certificate of eligibility). Step 5: Filling Out VA Form 10-10EZ-A. (For copies on paper) The information on your copy of the Records and Certificates page must match the information on those pages on Veterans' Record. Use the Copy of Records, Copy of Certificate of Eligibility, and DD-214 forms and pay the fee required. Copy of Records, Certificate of Eligibility (for copies on computer) (PDF 7.5 KB) Veterans' Record Request (for copies on computer) (PDF 8.2 KB) Certificate of Eligibility, Copy of Records, Copy of Certificate of Eligibility, and DD-214 (for copies on paper) (PDF 5.
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