Veteran Profile & VA Demographics | Veterans Claims Guide

👤 Veteran Avatar

💳 Access & Subscription

Current Plan: Veteran Access Plan

Status: ACTIVE ACCESS

📝 Veteran Short Bio & User Links

🔑 Change Security Password

📋 Official VA Form Demographics (Used to Pre-Populate Claims)

Enter the exact demographic header information required across all official Department of Veterans Affairs forms (VA Form 21-526EZ, 21-4138, 21-0781, 21-0966, etc.).

SECTION I: VETERAN IDENTIFICATION

FIRST NAME

MIDDLE NAME

LAST NAME

SUFFIX

SOCIAL SECURITY NUMBER (SSN)

VA FILE NUMBER / C-FILE

DATE OF BIRTH (MM/DD/YYYY)

GENDER / SEX

SECTION II: MAILING ADDRESS & CONTACT

STREET ADDRESS

APT / SUITE / UNIT

CITY

STATE

ZIP CODE

PRIMARY PHONE NUMBER

SECONDARY PHONE NUMBER

SECTION III: MILITARY SERVICE RECORD HEADER

BRANCH OF SERVICE

RANK / PAYGRADE

SERVICE NUMBER / EDIPI

CHARACTER OF DISCHARGE

ACTIVE DUTY ENTRY DATE

SEPARATION DATE