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Forms

This section provides access to forms related to programs and services offered by Veterans Affairs Canada.

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My VAC Account offers guided Web forms for many programs and services available from Veterans Affairs Canada. These forms are functional, easy to use, and designed based on feedback from Veterans. Your progress is saved as you make your way through the form, so you can come back at any time to continue your application. Sign in or register for My VAC Account.

Sending your application by mail

Mail applications for services, including supporting documents, to:

Veterans Affairs Canada
PO Box 6000, Matane, QC G4W 0E4

Form number Title of form Categories
VAC 749e Additional Information for Hearing Loss Claims
VAC 2504e Additional Pain and Suffering Compensation
PWGSC 540e Affidavit - For Cheques over $5,000 issued by the Receiver General
PWGSC 546-3e Affidavit - For Direct Deposit payments over $5,000 issued by the Receiver General
VAC 549e Allied Service Eligibility for Long-term Care Application
PEN 6240e Aneurysm and Embolus
PEN 6201e Applicant's Statement
VAC 1277e Application - Minor Disbursement Trust Funds
VAC 464e Application and Agreement for Departmental Administration
PEN 185Ae Application for Additional Pension (Dependants)
PEN 6203e Application for Attendance, Clothing or Exceptional Incapacity Allowance
VAC 609e Application for Benefits on Behalf of an Incapacitated Child of a Veteran/Member
VAC 1535e Application for Career Transition Services - Spouse/Common-law Partner or Survivor
VAC 1533e Application for Career Transition Services - Veteran, Member
VAC 1033e Application for Critical Injury Benefit
VAC 612e Application for Detention Benefit
PEN 542APe Application for Disability and/or Death Benefit for Survivor and Dependent Children
VAC 1537e Application for Education and Training Benefit
VAC 1503APe Application for Long Term Care Support
PEN 555e Application for Prisoner of War Compensation
DVA 1432e Application for Service Award of a Deceased Member of the Canadian Forces Second World War and Korean War including the Arctic Star
VAC 544e Application for the Canadian Volunteer Service Medal of a Deceased Member of the Royal Canadian Mounted Police
VAC 1571e Application for Veterans Emergency Fund
VAC 1466e Application for War Veterans Allowance
VAC 1466APe Application for War Veterans Allowance - Application Package
DVA 1433e Application of a Veteran for Service Awards - Second World War and Korean War including the Arctic Star
VAC 1278e Application to (RCNBF, Legion Poppy Fund, CFPAF, VAC, WVDF/FMTF, ETC.)
VAC 1128e Assistance Fund (WVA)
VAC 963e Authorization to use Audio/Visual Records
VAC 860e Biography Information - Youth
VAC 952e Bomber Command Bar Application Form
VAC 221e Canada Service Eligibility for the Veterans Independence Program
VAC 661e Canadian Forces Income Support (CFIS) Benefit Initial Application - Survivor
VAC 613e Canadian Forces Income Support (CFIS) Benefit Initial Application - Veteran
VAC 662e Canadian Forces Income Support (CFIS) Benefit Monthly Change Notification - Survivor
VAC 620e Canadian Forces Income Support (CFIS) Benefit Subsequent Application - Veteran
VAC 660e Canadian Forces Income Support (CFIS) Monthly Change Notification
VAC 663e Canadian Forces Income Support (CFIS) Subsequent Application - Survivor NSRD
VAC 1540e Caregiver Recognition Benefit (CRB) Application
VAC 530e Children of Deceased Veterans Education Assistance Act - Application for Special Benefit (Current Students)
VAC 531e Children of Deceased Veterans Education Assistance Act - Application for Special Benefit (Former Students between February 28, 1995 and August 31, 2003)
VAC 863e Commemorative Event Nomination Form
VAC 1068e Commemorative Partnership Program Community Engagement Funding Application
VAC 1064e Commemorative Partnership Program Community War Memorial Funding Application
VAC 834e Community War Memorial Program Application Form
VAC 934e Consent for Bureau of Pensions Advocates to Collect Personal Information from Third Parties
VAC 1021e Consent for the Bureau of Pensions Advocates (BPA) to Disclose Personal Information to Third Parties
VAC 1653e Consent for the Release of Personal Information Between Veterans Affairs Canada and The Manufacturers Life Insurance Company (Manulife), Canadian Armed Forces Long Term Disability (CAF LTD)
VAC 1722e Consent for the Release of Personal Information for the Administration of the Public Service Health Care Plan
VAC 928e Consent for Veterans Affairs Canada to Collect Personal Information from Third Parties
VAC 520e Consent for Veterans Affairs Canada to Disclose Personal Information to Third Parties
PEN 1050-2e Declaration as to Domicile - Dependant
PEN 1050-1e Declaration as to Domicile - Disability
VAC 922e Declaration for CFIS Spouse/Dependents
PEN 6205APe Departmental Review Application
VAC1703e Designation of Memorial Cross (1) and Memorial Ribbon Recipients - Spouse or Next of Kin - Service before 7 October 2001 and date of death before 12 December 2008
VAC 765e Designation of Memorial Cross Recipients
VAC1704e Designation of Memorial Cross Recipients - Second World War Service
VAC 760e Determination of Self-employment Earnings - Financial Benefit
VAC 441e Direct Deposit Request
VAC 441APe Direct Deposit Request - Rehabilitation Letter
PEN 923e Disability Benefits (Pain and Suffering Compensation/Disability Pension)
VAC 1572e Education and Training Benefit - Completion Bonus
VAC 1547e Education and Training Benefit - Formal Program Plan
VAC 1550e Education and Training Benefit - Monitoring Form
VAC 1573e Education and Training Benefit - Plan Amendment
VAC 1549e Education and Training Plan - Short Course
VAC 1416e Family Physician Assessment
VAC 1050e Financial Benefits - Income Verification - Survivor
VAC 717e Financial Benefits - Report on Earnings from Employment
PEN 1280e Financial Report
PEN 6202e General information - Disability Benefits
PEN 71e General Medical Questionnaire
VAC 752Ae Health Related Travel Claim - Veteran
VAC 752Ce Health Related Travel Guide
VAC 752De Health Related Travel Receipt - Escort
VAC 2524e Income Replacement Benefit - Income Verification
VAC 2526e Income Replacement Benefit for Orphan(s) Over 18
VAC 2527e Income Replacement Benefit for Orphan(s) Under 18
VAC 2507e Income Replacement Benefit for Survivor and Orphan(s) under 18
VAC 2502e Income Replacement Benefit for Veterans
PEN 6208e Medical Officer Consultation Request Form
PEN 6224e Medical Questionnaire: Ankle Conditions
PEN 6226e Medical Questionnaire: Elbow Joint Conditions
PEN 6222e Medical Questionnaire: Foot and Toe Conditions
PEN 6228e Medical Questionnaire: Fractures - Lower Limbs
PEN 6229e Medical Questionnaire: Fractures and Miscellaneous Musculoskeletal Conditions of the Chest and Upper Limbs
PEN 6223e Medical Questionnaire: Hip Conditions
PEN 6221e Medical Questionnaire: Knee Conditions
PEN 56e Medical Questionnaire: Neurological Conditions
PEN 6227e Medical Questionnaire: Thumb/Finger Conditions
PEN 6225e Medical Questionnaire: Wrist Conditions
PEN 6234e Medical Questionnaire: Activities of Daily Living
PEN 6230e Medical Questionnaire: Amputation of Upper and Lower Limbs
PEN 6253e Medical Questionnaire: Cardiorespiratory Conditions
PEN 6236e Medical Questionnaire: Cervical Spine Conditions
PEN 6237e Medical Questionnaire: Coccyx, Pelvis and Sacroiliac Joint Conditions
PEN 6238e Medical Questionnaire: Dental and Oral Conditions
PEN 62e Medical Questionnaire: Endocrine and Metabolic Conditions
PEN 6260e Medical Questionnaire: Esophageal and Gastroesophageal Junction Conditions
PEN 6249e Medical Questionnaire: Hearing Loss/Tinnitus
PEN 69e Medical Questionnaire: Hemopoietic Conditions
PEN 6255e Medical Questionnaire: Hernias and Pilonidal Sinus Disease
PEN 6241e Medical Questionnaire: Hypertension
PEN 6257e Medical Questionnaire: Liver and Gallbladder Conditions
PEN 6232e Medical Questionnaire: Lower Limb Function
PEN 63e Medical Questionnaire: Malignant Conditions
PEN 6259e Medical Questionnaire: Morbid Obesity
PEN 57Ae Medical Questionnaire: Nose, Throat, Sinus Conditions
PEN 6251e Medical Questionnaire: Obstructive Sleep Apnea
PEN 6252e Medical Questionnaire: Oral Cavity and Salivary Glands Conditions
PEN 6231e Medical Questionnaire: Osteomyelitis
PEN 6254e Medical Questionnaire: Pancreatic Conditions
PEN 6243e Medical Questionnaire: Peripheral Vascular Arterial Disease
PEN 6248e Medical Questionnaire: Psychiatric/Psychological Condition(s)
PEN 6242e Medical Questionnaire: Raynaud's Disease/Phenomenon and Frostbite, Immersion Foot and Other Cold Injuries
PEN 6220e Medical Questionnaire: Shoulder and Acromioclavicular Joint Conditions
PEN 6246e Medical Questionnaire: Skin Diseases and Burn Scars
PEN 6256e Medical Questionnaire: Small Bowel, Large Bowel, Rectal and Anal Conditions
PEN 6258e Medical Questionnaire: Stomach and Duodenal Conditions
PEN 6245e Medical Questionnaire: Superficial Skin Wounds and Scars
PEN 6235e Medical Questionnaire: Thoracolumbar Spine Conditions
PEN 6233e Medical Questionnaire: Upper Limb Function
PEN 68e Medical Questionnaire: Urinary, Sexual, Reproductive Conditions
PEN 6244e Medical Questionnaire: Varicose Veins and Deep Vein Thrombosis
PEN 6250e Medical Questionnaire: Vertigo/Ear Conditions
PEN 6239e Medical Questionnaire: Visual Conditions
VAC 1002e Medical Release Attributable to Service Determination
VAC1705e Memorial Cross Recipient Information - Second World War Service - Date of death before 24 December 2008
VAC 523e Mini-mental State Examination
VAC 1609e Minister of Veterans Affairs Commendation - Nomination Package
VAC 743e Psychological Progress Report
VAC 630e Public Service Health Care Plan (PSHCP) Eligibility for Clients of Veterans Affairs Canada (VAC)
VAC 754e Public Service Health Care Plan (PSHCP) Request for Cancellation of Plan for Clients of Veterans Affairs Canada
PEN 50e Quality of Life (QOL) Questionnaire
VAC 540e Record of Counselling and/or Client Consent
VAC 2522e Rehabilitation Services and Vocational Assistance Program for Spouse/Common-law Partner
VAC 2523e Rehabilitation Services and Vocational Assistance Program for Surviving Spouse/Common-law Partner
VAC 2533e Rehabilitation Services and Vocational Assistance Program, and Income Replacement Benefit (VAC2501 in My VAC Account)
VAC 1319e Report by Medical Examiner
VAC 2534e Request for Additional Pain and Suffering Compensation Grade Reassessment
VAC 791e Request for Address Change
VAC 808e Request for Confirmation of Allied Service
VAC 922Be Request for Extension of Treatment
VAC 611e Request for Payment/Reimbursement Re: Cost of Financial Advice
VAC 994e Second World War Tribute Request
VAC 1369e Statement of Income and Financial Status - Overpayment Review
VAC 165e Statutory Declaration
VAC 1080e Statutory Declaration Re: Lost Policy Contract
VAC 1525e Surviving Dependant Information
PEN 319e Surviving Dependant Information Under the Pension Act
VAC 1018e Travel Claim
VAC 918e Treatment Benefits Reimbursement Claim Form (POC 1-14)
PWGSC 536e Undertaking and Idemnity - For Direct Deposit payments issued by the Receiver General
PWGSC 535e Undertaking and Indemnity - For cheques issued by the Receiver General
PEN 100e Undertaking by Administrator for Administration of Account
VAC 755e VAC - Amendment - Public Service Health Care Plan (PSHCP)
VAC 844e Validation of Identity Bulletin
VAC 1679e Veterans Affairs Canada Ministerial Advisory Group Application Form
VAC 1145APe Veterans Independence Program Application
VAC 930e Veterans Independence Program Client Reimbursement Claim Form
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