Veterans Benefits Change of Address Form

Veterans Benefits Change of Address Form
Use this form to update your address for veterans benefits records. Please provide accurate information to ensure your records are updated promptly.
Full Name
First NameLast Name
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Previous Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
New Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Effective Date for Address Change
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional Comments (optional)
Should be Empty: