[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-276793-105":53,"doc-detail-276793-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","laywitness-statement-va-form-submission-instructions","LAY/WITNESS STATEMENT - VA form submission instructions","","Lay/Witness Statement collects supporting statements for U.S. Department of Veterans Affairs claims from veterans, claimants, or third parties writing on their behalf. The form explains privacy and respondent burden information, allows submission with an application, and includes directions for completing the veteran and (when applicable) claimant identification sections. It requests personal identifiers, VA file references, contact details, and mailing address data to facilitate evidence intake.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/laywitness-statement-va-form-submission-instructions/276793/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/laywitness-statement-va-form-submission-instructions/276793.png","ImageObject",442,249,{"name":88,"@type":89},"Ben Jamin","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-11-01","2026-09-15",true,{"@type":98,"interactionType":99,"userInteractionCount":30},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Who should complete the Lay/Witness Statement form?","Question",{"text":108,"@type":109},"A veteran/claimant or someone writing on the veteran’s or claimant’s behalf should complete it to support a VA claim.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"How should the form be submitted to VA?",{"text":113,"@type":109},"After completing the form, mail it to the Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444.",{"name":115,"@type":106,"acceptedAnswer":116},"What information is required in Section I?",{"text":117,"@type":109},"Section I collects the veteran’s identification details, including name and other VA-related identifiers, plus address and contact information. If the claimant is not the veteran, Section II must be completed.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},276793,1790055734,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":30,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},2336478466772,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","OMB Approved No.2900-0881Respondent Burden:10 Minutes  \nExpiration Date:07/31/2027  \n\n| Department of Veterans Affairs   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | VA DATE STAMP  \u003Cbr>(DO NOT WRITE IN THIS SPACE)   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| LAY/WITNESS STATEMENT   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| INSTRUCTIONS:Before completing this form,read the Privacy Act and Respondent Burden on page 3.Use this  \u003Cbr>form to submit a statement as a veteran/claimant or someone writing on your behalf to support a claim.If you or  \u003Cbr>someone else writing onyour behalf are providing additional statement(s)to support your claim(s)please submit this  \u003Cbr>form with your application.For more information,you can contact us through Ask VA:https://ask.va.gov/or call us  \u003Cbr>toll-free at 1-800-827-1000(TTY:711).VA forms are available at www.va.gov/vaforms.After completing the form,  \u003Cbr>mail to:Department of Veterans Affairs,Evidence Intake Center,P.0.Box 4444,Janesville,WI 53547-4444.   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| SECTION I:VETERAN'S IDENTIFICATION INFORMATION   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| NOTE:You may complete the form online or by hand.If completed by hand,print the information requested in ink,neatly and legibly,insert one letter per box,  \u003Cbr>and completely fill in each applicable circle to help expedite processing of the form.   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| 1.VETERAN'S NAME (First,Middle Initial,Last)   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| 2.SOCIAL SECURITY NUMBER(999-99-9999)   |  |  |  |  |  |  |  |  |  |  | 3.VA FILE NUMBER (If applicable)   |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4.DATE OF BIRTH (MM/DD/YYYY)  \u003Cbr>Year  \u003Cbr>Day  \u003Cbr>Month   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| -  \u003Cbr>一   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| 5.VA INSURANCE FILE NUMBER (If applicable)   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| 6.CURR  \u003Cbr>No.&   | ENT MAILING ADDRESS (If applicable)(Number and street or rural route,P.O.Box,City,State,ZIP Code and Country)   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| Street   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| Apt/Unit Number   |  |  |  |  |  |","cbCairgpCcmhOnN1","https://ap.wps.com/l/cbCairgpCcmhOnN1","pdf",928804,"English","# Instructions\n## Submission and contact information\n# Section I: Veteran's identification information\n## How to complete the form\n## Veteran identifiers and contact details\n# Section II: Claimant's identification information\n## When to complete claimant details","[{\"question\":\"Who should complete the Lay/Witness Statement form?\",\"answer\":\"A veteran/claimant or someone writing on the veteran’s or claimant’s behalf should complete it to support a VA claim.\"},{\"question\":\"How should the form be submitted to VA?\",\"answer\":\"After completing the form, mail it to the Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444.\"},{\"question\":\"What information is required in Section I?\",\"answer\":\"Section I collects the veteran’s identification details, including name and other VA-related identifiers, plus address and contact information. If the claimant is not the veteran, Section II must be completed.\"}]","LAY/WITNESS STATEMENT - VA form submission instructions | PDF",1789495328]