How to Fill Out VA Form 21-0845: Authorization to Disclose Personal Information

To fill out VA Form 21-0845, enter the veteran’s identifying information, name the person or organization you want to receive your information, check one box for the type of information to be shared, choose a security question and answer, set how long the authorization lasts in Item 13, then sign, date, and submit the form online, by fax, or by mail. The form lets the VA release your benefit or claim information to someone outside the VA. It does not give that person authority to act on your claim.¹

Two categories of information are off-limits no matter what you check. Federal tax information cannot be released through this form. Records on drug or alcohol treatment, HIV testing or treatment, and sickle cell anemia are protected under 38 U.S.C. § 7332 and need separate authorization.¹ And if the VA has recognized you as incompetent for VA purposes, you cannot execute this form yourself.

Fill In Your Identification Information

The first section asks for the veteran’s full legal name, Social Security number, date of birth, service number if applicable, and VA file number if you have one. Not every veteran has a VA file number; it is assigned during claims processing. If you don’t have one, leave that field blank rather than guessing or substituting another number.¹ If you’re using the paper PDF, type or print clearly in ink. Illegible entries slow processing.

Name Your Third Party

Enter the name and address of the person or organization you’re authorizing to receive your information. If you name an organization, also give the name of the specific individual within it who will be the contact. Include a reliable telephone number, because the VA uses this to verify the third party’s identity when they call.¹

Check One Information Category

Pick one, and only one, of the following boxes:

Pending claim or appeal status
Current benefit and rate
Payment history
Payment amount

The form is explicit that it “does not authorize the release of information other than that specifically described,” so the box you check defines the ceiling of what the VA will share.¹ Within that limit, the authorization covers VA benefits broadly, including disability compensation, education and training, and housing assistance.²

Choose a Security Question

You must select a security question and provide the answer. Every time your third party calls the VA, they’ll be asked this question to prove they are the person you authorized. Pick something the third party actually knows but that a stranger couldn’t guess, and tell them the answer before you submit the form. If they can’t answer correctly, the VA won’t release anything.¹

Set the Duration in Item 13

Item 13 controls how long the authorization lasts. You have three options:¹

One time only. The VA shares the information once and the authorization ends.
Ongoing until you notify the VA to stop. The authorization stays active indefinitely.
A specific date range. You write in the end date and the authorization expires automatically.

If you leave Item 13 blank, the form’s instructions indicate the authorization stays in effect indefinitely. For a short-term need, such as a spouse checking on a claim while you’re unavailable, the one-time option or a specific end date is cleaner than leaving it open.

Sign and Date

Sign and date the form at the bottom. Without your signature, the form will not be processed. Signing certifies that what you entered is true and correct.¹

Submit the Form

You have four ways to get the form to the VA:

Online. Complete and submit it directly at va.gov/forms/21-0845. This is the fastest route.²
QuickSubmit through AccessVA. Upload the completed PDF at eauth.va.gov/accessva. QuickSubmit replaced the older Direct Upload tool and sends documents to the VA’s Evidence Intake Center.³
Fax. Send it to 844-531-7818 for submissions within the United States.¹
Mail. Department of Veterans Affairs, Claims Intake Center, P.O. Box 4444, Janesville, WI 53547-4444.⁴

Online and fax submissions generally process faster than mailed forms because they go straight into the VA’s intake system.

How to Revoke or End the Authorization

You don’t need another form to cancel. The VA accepts revocation three ways: in writing, by calling 1-800-827-1000, or through Ask VA at ask.va.gov.¹ Once the VA is notified, it will stop disclosing your information going forward, though anything already shared cannot be pulled back. If you set an end date in Item 13, the authorization expires on its own. A one-time authorization ends after the single disclosure.

If You Need Someone to Act, Not Just Receive Information

Form 21-0845 only lets the VA share information. Your third party cannot sign anything, submit documents, or take action on your claim. If you need someone to actually manage your benefits, prepare and present claims, or access your full VA records, you need VA Form 21-22 or 21-22a instead.⁵

1
Department of Veterans Affairs. VA Form 21-0845 – Authorization to Disclose Personal Information to a Third Party
2
Veterans Affairs. VA Form 21-0845
3
U.S. Department of Veterans Affairs. QuickSubmit Is the New Evidence Intake Tool for VA Claims
4
Veterans Affairs. How to File a VA Disability Claim
5
Department of Veterans Affairs. VA Form 21-22a – Appointment of Individual as Claimant’s Representative