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VAU.S. Department of Veterans Affairs
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VA Form 21P-527EZ ยท v4.2 draft

Veterans Pension application

Long income and asset sections. The draft adds bank statement reading to pre-fill income, with every value held for confirmation.

In review
warning

2 fields have no downstream target

Those answers are captured on the intake record but are not sent anywhere yet. A person has to choose the mapping before they can flow downstream.

6 fields in v4.2 draft

Each field records where it came from on the paper form, so a reviewer can always trace a digital answer back to the box it replaced.

Field schema for VA Form 21P-527EZ

  • Field
    veteran_full_nameVeteran's full name
    Type
    Text
    Required
    Yes
    On the paper form
    Page 1, Section I, box 1
    Maps to
    claimant.fullName
  • Field
    service_startService start date
    Type
    Date
    Required
    Yes
    On the paper form
    Page 2, Section IV, box 12a
    Maps to
    service.startedOn
  • Field
    monthly_incomeMonthly income
    Type
    Currency
    Required
    Yes
    On the paper form
    Page 5, Section VII, box 30
    Maps to
    income.monthlyTotal
  • Field
    net_worthTotal net worth
    Type
    Currency
    Required
    Yes
    On the paper form
    Page 6, Section VIII, box 34
    Maps to
    assets.netWorth
  • Field
    unreimbursed_medicalUnreimbursed medical expenses
    Type
    Currency
    Required
    No
    On the paper form
    Page 6, Section VIII, box 36
    Maps to
    Unmapped
  • Field
    care_facility_nameCare facility name
    Type
    Text
    Required
    No
    On the paper form
    Page 7, Section IX, box 41
    Maps to
    Unmapped