VA · Official form

VA Form 21-0845: Authorization to Disclose Personal Information to a Third Party

VA Form 21-0845 gives VA written permission to discuss or release your personal claim information to a specific person or organization you choose, such as a spouse or a member of Congress's office.

This is the genuine VA PDF, unmodified. Source: VA official page.

What is VA Form 21-0845?

VA Form 21-0845, Authorization to Disclose Personal Information to a Third Party, is a privacy release. Without it, VA cannot discuss the details of your claim with anyone other than you or your appointed representative. The form lets you name a third party, either an individual or an organization, and define what VA may share with them.

You can limit the disclosure to specific information and set a security question or code the third party must provide. The authorization is not the same as appointing a representative: the named person can receive information but cannot act on your claim. You can revoke the authorization in writing at any time.

Who files VA Form 21-0845?

  • Veterans who want VA to be able to discuss their claim with a spouse or family member
  • Claimants authorizing a congressional office or other organization to receive claim information
  • Beneficiaries who want a trusted helper kept informed without appointing a representative
  • Anyone updating or revoking a previous third-party disclosure authorization

How to fill out VA Form 21-0845

  1. Enter your name, file number, and identifying information.
  2. Name the individual or organization VA may release information to.
  3. Specify what information VA may disclose, or authorize release of any information about your claim.
  4. Set the optional security question or code the third party will use, then sign and date the form.
  5. Submit it online, upload it through va.gov, or mail it to the address in the form instructions.

Quick fill VA Form 21-0845 on this page

Prefer to see the form itself while you type? Open VA Form 21-0845 in the editor to fill it on the actual pages, add a signature, and download.

These are the form's own fields, in the order they appear on the pages. Fill in what you know; anything left blank stays a fillable field in the PDF, so you can finish it in any PDF reader. Nothing you type here is sent to VA.

Page 2 47 fields
Page 3 29 fields

Processed on our own servers, never sent to a third-party service. Files are deleted automatically after two hours, and you can delete them sooner from the result screen.

Frequently asked questions

Does VA Form 21-0845 let someone act on my claim?

No. It only authorizes VA to release information to that person or organization. To have someone act for you, appoint a representative with VA Form 21-22 (for a service organization) or 21-22a (for an individual).

Can I cancel the authorization later?

Yes. You can revoke it at any time by sending VA a written statement. The revocation takes effect when VA receives it and does not undo disclosures already made.