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|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| STATEMENT OF MARITAL RELATIONSHIP   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| INSTRUCTIONS:Before completing this form,read the Privacy Act and Respondent Burden on Page 4.Use this form to  \u003Cbr>provide information to VA to determine your marital status.For more information,contact VA online through Ask VA:  \u003Cbr>https:/ask.va.gov,or call us toll-free at 1-800-827-1000.If you use a Telecommunications Device for the Deaf(TDD),the  \u003Cbr>Federal relay number is 711.VA forms are available at www.va.gov/vaforms.See mailing information on page 5.   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| IMPORTANTINFORMATION:This form is to be completed by the veteran(ifliving)and the person who is claiming o b the spouse or suriving spouse of the  \u003Cbr>veteran.Note:For the purposes of this form,the person who is claiming to be te spouse or surviving spouse of the veteran is referred to s such.If you do not knowthe  \u003Cbr>answer,write \"unknown\".Submit any documents that show your marital status as holding yourselves out as married or whether you are generally accepted as such in  \u003Cbr>the community in which you live orlived.For example,lease agreements,jointbankstatements,utility bills,tax returns,insurance formsemployment records,and any  \u003Cbr>other documents showing marital status.Be advised that original documents will not be returned to you.We highly encourage you to submit certified copies instead.If  \u003Cbr>additional space is needed,use Section VI:Remarks,indicating the item number to which the answers apply.   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| SECTIONI-VETERAN'S IDENTIFICATION INFORMATION   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| NOTE:You may fill out the form online or by hand.If completed by hand,print the information neatly and legibly,insert one letter per box,and completely fill in  \u003Cbr>each applicable check box to help expedite processing of the form.   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| 1.VETERAN'S NAME(First,Middle Initial,Last)   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  ","cbCaiikouyZiemC2","https://ap.wps.com/l/cbCaiikouyZiemC2","pdf",967018,"English","# Instructions\n## Privacy Act and Respondent Burden\n# Veteran 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