General Instructions

  1. Browse the Available Forms below.
  2. Expand the form details by clicking the + symbol to the left of the form name.
  3. Click on the Download Link which will open the form as an editable portable document format (PDF).
  4. Fill out the appropriate fields, then save the completed form to your computer.
  5. Upload the form at the bottom of this page, selecting your Veterans Service Officer (VSO) or Financial Assistance Investigator (FAI).

Should you have any questions at all, please don’t hesitate to give us a call (440) 284-4625 or send an email. We are here to help.

Event Sponsorship

Lorain County Veterans Service Commission may provide sponsorship for veteran-focused events hosted by Veterans Service organizations and community agencies.
Download LCVSC Event Sponsorship Request (PDF)

Available Forms (ordered by form number)

This document provides general information about what information we my need to collect for processing claims on your behalf.
Download LCVSC General Info Sheet (PDF)

The Attendant Affidavit must be completed by the home health care service or individual caring for the applicant. This allows the VA to consider the cost of care as a deductible medical expense.
Download LCVSC Form 21-AA (PDF)

This form is used to assist our clients when they ask us to get information from government agencies.
Download LCVSC Form 21-RFI (PDF)

Use VA Form 21-0779 if you’re a resident of a nursing home and you’re providing supporting information for your claim application for VA Aid and Attendance benefits.
Download VA Form 21-0779 (PDF)

Use VA Form 21-0966 if you’re still gathering information to support your claim, and want to start the filing process. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.
Download VA Form 21-0966 (PDF)

Use VA Form 21-22 when you want to have a Veterans Service Organization (VSO) help you with VA benefits or claims.
Download VA Form 21-22 (PDF)

Use VA Form 21-2680 to apply for Aid and Attendance benefits that will be added to your monthly compensation or pension benefits.
Download VA Form 21-2680 (PDF)

Use VA Form 21-686c to submit a claim for additional benefits for a dependent, or to request to remove a dependent from your benefits.
Download VA Form 21-686c (PDF)

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