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12th Annual Federal Workers' Compensation Conference S i #39 ...

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Veteran’s Administration<br />

• Information<br />

• Date and Place of<br />

needed:<br />

Birth<br />

• Full Name and<br />

Military Rank<br />

• Branch of Service<br />

• Social Security<br />

Number<br />

• Service Number<br />

• VA Claim Number<br />

(if applicable)<br />

• Date and Place of<br />

Death<br />

• Date of Retirement<br />

or last Separation<br />

from active duty.<br />

• Copy of any<br />

military<br />

documents, such<br />

as DOD form 214<br />

(DD-214)<br />

57

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