Department of Veterans Affairs Incarceration Notice

To submit this form, you may choose to do so by mail, in-person at a VA regional office, or electronically. For electronic submissions, visit the VA's website for detailed instructions on uploading documents and the QuickSubmit service. If mailing, the Compensation Intake Center's address is PO Box 4444, Janesville, WI 53547, with toll-free numbers available for additional assistance.

The key date to remember is the expiration of the associated VA form which is set for 10/31/2025. This form needs to be submitted promptly to avoid interruptions in benefits. Review and adhere to any local legal deadlines for submission as needed.

The primary purpose of this form is to inform the Department of Veterans Affairs about any veterans or beneficiaries who are incarcerated, thus necessitating adjustments to their benefits. It ensures compliance with Title 38 of the U.S. Code, which governs the eligibility and management of VA benefits. By submitting this form, authorized individuals help maintain the integrity and accuracy of the VA benefits distribution system.

• 1. Veteran/Beneficiary's Name: First, Middle Initial, Last Name of the veteran or beneficiary.
• 2. Social Security Number: The SSN for identification purposes.
• 3. VA File Number: The unique file number assigned by the VA.
• 4. Veteran's Date of Birth: The date of birth of the veteran (Month/Day/Year).
• 5. Type of Offense: Describes the nature of the offense committed.
• 6. Date of Conviction: The date when the conviction occurred.
• 7. Scheduled Release Date: The anticipated date for the individual's release from incarceration.
• 8. Institution Telephone Number: Contact number for the institution where the veteran is held.

Failure to submit this form in a timely manner may result in the discontinuation of VA benefits for the affected veteran or beneficiary. This could lead to significant financial difficulties and disrupt access to essential services. It is critical to ensure that the form is completed and submitted according to the provided guidelines to avoid such complications.

• Loss of Benefits: Without submission, benefits will be paused or discontinued.
• Inaccurate Record Keeping: Delayed submission can lead to discrepancies in VA records.
• Legal Compliance Issues: Failure to report incarceration may lead to legal ramifications.

• 1. Reporting Incarceration: Notify the VA of any veteran's incarceration.
• 2. Benefits Adjustment: To adjust or discontinue benefits during incarceration.
• 3. Compliance with Legal Requirements: To meet the requirements set forth by Title 38.