VA Pre-Qualification

Name
First Last
Phone
Address*
Street Address Address Line 2 City State ZIP Code
Consent
I agree to receive mobile text notification. You can Opt-Out at anytime.
Email

Are you receiving Dependency & Indemnity Compensation (DIC)?
- Yes
- No
Please upload the Veterans DD214
If you’re receiving Dependency & Indemnity Compensation (DIC) please upload the completed VA Form 26-1817
Please upload VA Form 21P-534EZ
Please upload your marriage certificate
Accepted file types: pdf, jpg, png.
Please upload the veterans Death certificate
Accepted file types: pdf, jpg, png.
Please Upload your Statement of Service-Signed by your commander, adjutant, or personnel officer.
Please upload your DD214
Accepted file types: pdf, jpg, png, dox, doc.
Please upload your Report of Separation and Record of Service (NGB Form 22) for each period of National Guard service
Drop files here or

Accepted file types: pdf, jpg, dox.

Are a U.S. citizen who served in the Armed Forces of a government allied with the United States in World War II,
Public Health Service officer
Cadet at the United States Military, Air Force, or Coast Guard Academy
Midshipman at the United States Naval Academy
Officer of the National Oceanic & Atmospheric Administration
Merchant seaman during World War II