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NOTE TO VETERANS: Most WDVA benefits may be initiated through your local County Veterans Service Officer (CVSO) or directly with the Wisconsin Department of Veterans Affairs. Applications for many benefits can be submitted online, and online applications are clearly marked.

For more information about specific programs, please visit WDVA's State Veterans Benefits section.

Not sure how to contact your local CVSO?  Check our statewide CVSO listing.

• Applications for the Assistance to Needy Veterans and Family Members Grant must be submitted through your local CVSO.

Our forms are all available in Adobe Acrobat PDF format. Adobe documents can be opened and printed across a wide range of computer platforms through the use of a free Adobe Acrobat Reader software program available here.

Many forms are also available as a Microsoft Word 97 document or a Microsoft Word 97 fillable document. Fillable documents can be completed when opened in Word, saved, and printed with the typed input. The other Word documents can only be printed and completed manually.

Form Categories
General | Burial & Memorial Benefits | Grants | Loans | Training Manual
Veterans Homes

Left click an icon below in the Format column to open the file Right click an icon below to save the file to your computer
= Adobe format	= Apply online
= fillable Word 97 format	= Word 97 print-only format

Form #	Form Title / Revision date	Format
General
WDVA 0001	Eligibility Determination (09/10)
WDVA 0001E	Non-Remarriage Certificate (09/06)
WDVA 0005	Notarized Residence Affidavit (09/06)
WDVA 1015	Certification of Validity for Military Separation Records and/or Other Veterans Records (11/07)
WDVA 1035	Income Tax Release Authorization (08/09)
WDVA 1037	Veteran-Owned Business — Request for Certification (02/12)
WDVA 1045	Request for Release and/or Discussion of Veterans Records (01/08)
WDVA 1076	Pre-Authorized ACH Debits Agreement — Direct Withdrawal (04/01)
WDVA 1087	Home of Record Notarized Affidavit (10/07)
WDVA 1089	Resident Veteran Certification Request / Release (08/04)
WDVA 1805	Veteran's Residency Affidavit
WDVA 2304	Request for Verification of Employment (07/98)
WDVA 2352	Claims Fax Transmittal Sheet (10/10)
Burial & Memorial Benefits
WDVA 2111	Pre-registration for Cemetery Interment (05/03)
WDVA 2800	Military Funeral Honors Request (03/12)
WDVA 2801	Military Funeral Honors Stipend Reimbursement Request (03/12)
WDVA 2802	"Taps" Tuition/Fee Voucher (08/03)
W-9 (DOA)	Taxpayer Identification Number (TIN) Verification with instructions for Military Funeral Honors Stipend Reimbursement Program
Grants Assistance to Needy Veterans (ANV) - Retraining (RTG) - Veterans Education (VetEd) - Veterans Service ( VS)
Online	(ANV) Assistance to Needy Veterans and Family Members
VA 10-5345	(ANV) Request for and Authorization to Release Medical Records or Health Information (11/04)
WDVA 2045	(ANV) Verification of Illness or Disability (07/08)
WDVA 2090	(ANV) Explanation of Accident or Injury (03/02)
WDVA 2450	(ANV) Assistance to Needy Veterans Grant Application (02/11)
WDVA 2451	(ANV) Declaration of Aid (10/09)
WDVA 2019	(RTG) Retraining Grant Application (08/10)
WDVA 2039	(RTG) Retraining Grant Application — OJT (05/02)
WDVA 2085	(RTG) Request for Second Payment (02/06)
Online	(VetEd) Veterans Education Grant
WDVA 2200	(VetEd) Veterans Education Grant Application (01/10)
WDVA 0055	(VS) County Veterans Service Grant Application Packet (01/12)
WDVA 0056	(VS) American Indian Veterans Service Grant Application Packet (01/12)
Loans Home Improvement (HILP) - Personal (PLP) - Primary Mortgage(PML)
WDVA 2077	(PLP) Loan Deferment Request (03/07)
WDVA 2411	(PML) Loan Service Report (03/02)
WDVA 2413	(PML) Foreclosure Expense Claim (03/02)
WDVA 2420	(PML) Property Inspection Report (03/02)
Veterans Service Officer Training Manual
WDVA M2007	Veterans Service Officer Training Manual (03/11)
Admission to Wisconsin Veterans Homes
VA 10-10EZ	Application for Health Benefits (11/09)
VA 10-5345	Request for and Authorization to Release Medical Records or Health Information (05/05)
WDVA 4000	Application for Admission to the Wisconsin Veterans Home (04/12)
WDVA 4001	Applicant's Financial Statement (04/12)
WDVA 4002	Authorization for Disclosure of Health Information (04/12)
WDVA 4003	Veteran's Residency Affidavit for Applications to a Veterans Home (04/12)
WDVA 4004	Medical Care Determination (04/12)
WDVA 4006	Applicant Admissions Checklist — Wisconsin Veterans Homes (04/12)
WDVA 4020F	Admission Agreement — Attachment F — Privacy Practices (04/12)
WDVA B3401	Wisconsin Veterans Home at King — Caring for America's Heroes (01/12)
WDVA P4015	Wisconsin Veterans Homes — Wonderful places to live! (10/10)