OMB control number

Statement of Dependency of Parent(s) (VA Form 21-509)

OMB 2900-0089 · VA.

OMB 2900-0089

VA Form 21-509 is the prescribed form used by VBA to gather income and dependency information from claimants who are seeking payment of benefits as, or for dependent parent(s). VA Form 21-509 is used by a Veteran seeking to establish their parent(s) as dependent(s) and by a surviving parent seeking death compensation. This information is used to determine the dependency of the parent and make determinations which affect the payment of monetary benefits to the claimant. Without this information, determination of entitlement would not be possible.

The latest form for Statement of Dependency of Parent(s) (VA Form 21-509) expires 2027-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 21-509 Statement of Dependency of Parent(s) (VA Form 21-509) Form
30-Day FRN - 2900-0089 (2024).pdf Supplementary Document
2024-02739, 60-Day FRN (VAF21-509).pdf Supplementary Document
2900-0089, Supporting Statement (VAF21-509).docx Supporting Statement A
Statement of Dependency of Parent(s) (VA Form 21-509) Form

All Historical Document Collections

202402-2900-005 Approved without change	Revision of a currently approved collection	2024-04-17
202009-2900-025 Approved without change	Reinstatement with change of a previously approved collection	2021-02-10
201708-2900-002 Approved without change	Reinstatement with change of a previously approved collection	2017-11-15
201306-2900-003 Approved with change	Revision of a currently approved collection	2014-03-13
201009-2900-021 Approved without change	Extension without change of a currently approved collection	2010-12-23
200707-2900-018 Approved without change	Extension without change of a currently approved collection	2007-12-06
200411-2900-002 Approved without change	Extension without change of a currently approved collection	2004-11-05
200202-2900-009 Approved without change	Extension without change of a currently approved collection	2002-02-11
200201-2900-008 Withdrawn and continue	Extension without change of a currently approved collection	2002-01-18
200003-2900-010 Approved without change	Reinstatement without change of a previously approved collection	2000-03-29
199612-2900-003 Approved without change	Reinstatement without change of a previously approved collection	1996-12-02
199508-2900-034 Approved without change	Extension without change of a currently approved collection	1995-08-28
199212-2900-004 Approved without change	Revision of a currently approved collection	1992-12-02
199001-2900-002 Approved without change	Reinstatement with change of a previously approved collection	1990-01-22
198608-2900-004 Approved without change	Revision of a currently approved collection	1986-08-15
198403-2900-004 Approved without change	Extension without change of a currently approved collection	1984-03-20
198103-2900-004 Approved without change	Extension without change of a currently approved collection	1981-03-23
197606-2900-016 Approved without change	Revision of a currently approved collection	1976-06-25