Benefits Forms
Browse official and fillable benefits PDFs. Open a form to fill it online, download a blank copy, or print it for filing.
Find the right benefits form
Benefits forms are commonly used by people and teams preparing official paperwork. This hub organizes 641 fillable PDFs so you can find the right document, fill it online, download a blank copy, and keep a record for filing.
Filing checklist
- Open the form detail page and verify the agency, year, revision date, and source link.
- Read the official instructions before submitting the completed form.
- Check the issuing authority, form number, revision label, and any filing instructions before submitting.
- Keep a copy of the completed PDF and any confirmation receipt from the official filing channel.
641 Benefits Forms
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VA Form 10-2479C(2011)
Request for Web Survey or Form Number - fillable
Official Department of Veterans Affairs 10-2479C for Request for Web Survey or Form Number - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-253(2020)
Ecclesiastical Endorsement for Veterans Affairs Chaplaincy
Official Department of Veterans Affairs 10-253 for Ecclesiastical Endorsement for Veterans Affairs Chaplaincy, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2553(2019)
Certificate of Residency
Official Department of Veterans Affairs 10-2553 for Certificate of Residency, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2553A(2019)
Certificate of Internship
Official Department of Veterans Affairs 10-2553A for Certificate of Internship, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2596(1996)
Identification Tag
Official Department of Veterans Affairs 10-2596 for Identification Tag, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2615(1972)
Laundry List
Official Department of Veterans Affairs 10-2615 for Laundry List, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2623(2024)
Proficiency Report - Electronic Signatures
Official Department of Veterans Affairs 10-2623 for Proficiency Report - Electronic Signatures, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2623A(2024)
Proficiency Report
Official Department of Veterans Affairs 10-2623A for Proficiency Report, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2623C(1991)
Nurse Executive Proficiency Rating System (Nurse IV)
Official Department of Veterans Affairs 10-2623C for Nurse Executive Proficiency Rating System (Nurse IV), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2623D(1998)
Nurse Executive Proficiency Rating System (Nurse V)
Official Department of Veterans Affairs 10-2623D for Nurse Executive Proficiency Rating System (Nurse V), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2633(1990)
Report of Special Incident Involving a Beneficiary - fillable
Official Department of Veterans Affairs 10-2633 for Report of Special Incident Involving a Beneficiary - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2636(1989)
Envelope for Dental Radiograph - fillable
Official Department of Veterans Affairs 10-2636 for Envelope for Dental Radiograph - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2636A(1992)
Envelope for Panoramic Dental Radiographs
Official Department of Veterans Affairs 10-2636A for Envelope for Panoramic Dental Radiographs, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2641(2008)
Authority for Issuance of Special and/or Experimental Appliances
Official Department of Veterans Affairs 10-2641 for Authority for Issuance of Special and/or Experimental Appliances, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2649A(2025)
Inter-Facility Transfer Form
Official Department of Veterans Affairs 10-2649A for Inter-Facility Transfer Form, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2675(1992)
Consolidated Requisition for Cash Withdrawals - Order from SDC #F05239
Official Department of Veterans Affairs 10-2675 for Consolidated Requisition for Cash Withdrawals - Order from SDC #F05239, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2675C(1989)
Consolidated Requisition for Cash Withdrawals (Continuation Sheet)
Official Department of Veterans Affairs 10-2675C for Consolidated Requisition for Cash Withdrawals (Continuation Sheet), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2683(1958)
Monthly Report of Restraint and Seclusion
Official Department of Veterans Affairs 10-2683 for Monthly Report of Restraint and Seclusion, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2687(1974)
Inventory of Funds and Effects
Official Department of Veterans Affairs 10-2687 for Inventory of Funds and Effects, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2688(1964)
Dental Master Card
Official Department of Veterans Affairs 10-2688 for Dental Master Card, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2743(2009)
Report of Seriously Ill
Official Department of Veterans Affairs 10-2743 for Report of Seriously Ill, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2770(2007)
VA Orthopedic Shoe Repair Ticket - fillable
Official Department of Veterans Affairs 10-2770 for VA Orthopedic Shoe Repair Ticket - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2804A(2008)
Crown and Bridge Laboratory Prescription
Official Department of Veterans Affairs 10-2804A for Crown and Bridge Laboratory Prescription, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2804B(2008)
Removable Partial Denture Laboratory Prescription
Official Department of Veterans Affairs 10-2804B for Removable Partial Denture Laboratory Prescription, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
Common mistakes to avoid
- Using an outdated edition when the issuing authority has published a newer version.
- Leaving signature, date, identification number, or required attachment fields blank.
- Submitting the completed form to the wrong agency, department, or upload portal.