Step 1 of 2 50% This is an online form. You can easily complete the form from any desktop computer, tablet or mobile device and submit it online. You will automatically receive a confirmation of receipt. If there are attachments, you can even do those online as well. If you do not have all the required documentation, the submission will not go through. Don't forget that if you have any questions or requests please don't hesitate to let us know. By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored. Name(Required) Address(Required) Phone(Required) Parcel Id(Required) Marital Status(Required) Telephone Date of Birth(Required) Indicate Status:(Required) Qualified veteran Surviving Spouse Parent of soldier/sailor Date of veterans death Did you Own and occupy the above property as your primary residence as of July 1, 2022?(Required) Yes No Is the property Subject to a Trust as of July 1, 2022?(Required) Yes No ***Please provide a copy of the “Schedule of Beneficiaries” from the trust documents.***Has your Marital Status changed in the past year?(Required) Yes No Indicate your Current marital status As a veteran, was your Disability rating changed by the Veterans' Administration in the past year?(Required) Yes No Current disability percentage If you are now entitled to 100% disability, a copy of your VA Benefits letter dated no later than July 1st 2022 must accompany this application. If you are a recent widow(er); of a qualified veteran, please provide a copy of your spouse’s death Certificate with this application. I have read this return. Under the pains and penalties of perjury I declare to the best of my knowledge and belief, the return is true, correct and complete. Signature(Required)DATE MM slash DD slash YYYY Please upload VA Benefits letter, spouse's death certificate and/or copy of the "Schedule of Beneficiaries" if applicable Drop files here or Select files Max. file size: 50 MB.
