Supporting nursing-home information for the pension care-needs request; PDF prints a different general intake address
Department of Veterans Affairs
Pension Intake Center
PO Box 5365
Janesville, WI 53547-5365
VA Form 21-0779 — Provide nursing-home information
Have a nursing-home official provide information for an applicable Aid and Attendance claim. Use the instructions for that benefit.
Use the current official form
Revision: September 2023.
The September 2023 21-0779 PDF prints Evidence Intake Center PO Box 4444. Current pension Aid and Attendance instructions give Pension Intake Center PO Box 5365.
The pension guide uses the current pension-specific destination. The form registry preserves the differing PDF address and its scope instead of presenting a universal address.
These are reviewed, scoped methods. Read the current official program and PDF instructions for conditions, signatures, additional methods and exceptions.