VA Form 21-0788, Information Regarding Apportionment of Beneficiary's Award Instructions

Check this box if the spouse who is claiming an apportionment is living with another person and is holding himself/herself out publicly as that person's spouse. Fill only if '4B. Relationship to Veteran' is 'Spouse'.

Check this box if the spouse who is claiming an apportionment is not living with another person and is not holding himself/herself out publicly as that person's spouse. Fill only if '4B. Relationship to Veteran' is 'Spouse'.

Check this box if the veteran's child(ren) being claimed have been legally adopted by another person. Fill only if '4B. Relationship to Veteran' is 'Child'.

Check this box if the veteran's child(ren) being claimed have not been legally adopted by another person. Fill only if '4B. Relationship to Veteran' is 'Child'.

Enter the full name (first, middle initial, and last) of the person for whom you are requesting an apportionment.

Enter the claimant's relationship to the veteran (for example: spouse, child, dependent parent).

Enter how often contributions are made to the claimant by the veteran or surviving spouse (for example: monthly, weekly, annually, or one-time). Fill only if '4A. Claimant's Name' is filled.

Enter the total amount the veteran or surviving spouse is contributing to the person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly gross amount of this other income that is received by the veteran or surviving spouse.

Enter a brief description of the other income source (for example, rental income, dividends, or part‑time earnings).

Enter the monthly gross amount of this other income that is received by the custodian.

Enter the monthly gross amount of this other income apportioned to the first person for whom apportionment is claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly gross amount of this other income apportioned to the second person for whom apportionment is claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the veteran's or surviving spouse's gross monthly wages from all employment before any deductions.

Enter the custodian's gross monthly wages from all employment before any deductions.

Enter the gross monthly wages from all employment for the first person for whom an apportionment is being claimed before any deductions. Fill only if '4A. Claimant's Name' is filled.

Enter the gross monthly wages from all employment for the second person for whom an apportionment is being claimed before any deductions. Fill only if '4A. Claimant's Name' is filled.

Enter the gross monthly Supplemental Security Income (SSI) or public assistance amount received by the veteran or surviving spouse before any deductions.

Enter the gross monthly Supplemental Security Income (SSI) or public assistance amount received by the custodian before any deductions.

Enter the gross monthly Supplemental Security Income (SSI) or public assistance amount received by the first person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the gross monthly Supplemental Security Income (SSI) or public assistance amount received by the second person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly Social Security amount received by the veteran or surviving spouse to be reported on line 1B.

Enter the monthly Social Security amount received by the custodian to be reported on line 1B.

Enter the monthly Social Security amount received by the first person for whom an apportionment is being claimed on line 1B. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly Social Security amount received by the second person for whom an apportionment is being claimed on line 1B. Fill only if '4A. Claimant's Name' is filled.

Enter the name or brief description of the other income source being reported on the sixth 'Other Income' line.

Enter the monthly amount of other income received by the veteran or surviving spouse for this source.

Enter the monthly amount of other income allocated to the custodian for this source.

Enter the monthly amount of other income apportioned to the first person for whom apportionment is claimed for this source. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly amount of other income apportioned to the second person for whom apportionment is claimed for this source. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly retirement or annuity income amount received by the veteran or surviving spouse to report for apportionment.

Enter the monthly retirement or annuity income amount received by the custodian to report for apportionment.

Enter the monthly retirement or annuity income amount received by the first person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the monthly retirement or annuity income amount received by the second person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total amount currently held in cash or non‑interest‑bearing bank accounts owned by the veteran or surviving spouse.

Enter the total amount currently held in cash or non‑interest‑bearing bank accounts held by a custodian on behalf of the veteran or claimant.

Enter the total amount currently held in cash or non‑interest‑bearing bank accounts for the first person for whom apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total amount currently held in cash or non‑interest‑bearing bank accounts for the second person for whom apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total current monetary value of all interest-bearing bank accounts owned by the veteran or surviving spouse to be included in net worth.

Enter the total current monetary value of all interest-bearing bank accounts held by the custodian to be included in net worth.

Enter the total current monetary value of all interest-bearing bank accounts owned by the first person for whom apportionment is claimed to be included in net worth. Fill only if '4A. Claimant's Name' is filled.

Enter the total current monetary value of all interest-bearing bank accounts owned by the second person for whom apportionment is claimed to be included in net worth. Fill only if '4A. Claimant's Name' is filled.

Enter the current total value of IRAs, Keogh plans, and similar retirement accounts owned by the veteran or surviving spouse.

Enter the current total value of IRAs, Keogh plans, and similar retirement accounts held by the custodian.

Enter the current total value of IRAs, Keogh plans, and similar retirement accounts for the first person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the current total value of IRAs, Keogh plans, and similar retirement accounts for the second person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total net worth amount of stocks, bonds, mutual funds, and similar investment holdings owned by the veteran or surviving spouse.

Enter the total net worth amount of stocks, bonds, mutual funds, and similar investments held by a custodian on behalf of the veteran or claimant.

Enter the total net worth amount of stocks, bonds, mutual funds, and similar investments owned by the first person for whom apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total net worth amount of stocks, bonds, mutual funds, and similar investments owned by the second person for whom apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total current value of real property (not the veteran's primary home) owned by the veteran or surviving spouse that applies to this apportionment row.

Enter the total current value of real property (not the veteran's primary home) owned by the custodian that applies to this apportionment row.

Enter the total current value of real property (not the veteran's primary home) owned by the person for whom apportionment is being claimed in this column. Fill only if '4A. Claimant's Name' is filled.

Enter the total current value of real property (not the veteran's primary home) owned by the other person for whom apportionment is being claimed in this column. Fill only if '4A. Claimant's Name' is filled.

Enter the total value of all other property and assets owned by the veteran or surviving spouse to be included in net worth.

Enter the total value of all other property and assets held by a custodian on behalf of the veteran or claimant to be included in net worth.

Enter the total value of all other property and assets attributed to the first person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter the total value of all other property and assets attributed to the second person for whom an apportionment is being claimed. Fill only if '4A. Claimant's Name' is filled.

Enter any additional comments, explanations, or details relevant to your monthly living expenses or other information you want the reviewer to know for Item 8 (REMARKS).

Enter the date when the veteran or claimant signed the form.

Enter the full name (first, middle initial, last) of the person completing this form if other than the veteran.

Enter the mailing address for the person completing the form, including number and street or rural route, city or P.O., state, and ZIP code.

Enter the daytime telephone number for the person completing the form, including the area code.

Enter the evening telephone number for the person completing the form, including the area code.

Enter the e-mail address for the person completing the form, if applicable.

Enter the monthly rent or mortgage (house) payment amount paid by the veteran or surviving spouse.

Enter the monthly rent or mortgage payment amount paid by the custodian.

Enter the monthly rent or mortgage amount for the first person for whom an apportionment is claimed.

Enter the monthly rent or mortgage amount for the second person for whom an apportionment is claimed.

Enter the monthly dollar amount the veteran or surviving spouse pays for food.

Enter the monthly dollar amount the custodian pays for food.

Enter the monthly dollar amount of food expenses being claimed for the first apportioned person.

Enter the monthly dollar amount of food expenses being claimed for the second apportioned person.

Enter the monthly utilities amount for water, gas, and electricity paid by the veteran or surviving spouse.

Enter the monthly utilities amount for water, gas, and electricity paid by the custodian.

Enter the monthly utilities amount for water, gas, and electricity for the first person for whom apportionment is claimed.

Enter the monthly utilities amount for water, gas, and electricity for the second person for whom apportionment is claimed.

Enter the monthly telephone expense amount for the veteran or surviving spouse; write "0" or "none" if there is no expense.

Enter the monthly telephone expense amount for the custodian; write "0" or "none" if there is no expense.

Enter the monthly telephone expense amount for the first person for whom apportionment is claimed; write "0" or "none" if there is no expense.

Enter the monthly telephone expense amount for the second person for whom apportionment is claimed; write "0" or "none" if there is no expense.

Enter the monthly clothing expenses paid by the veteran or surviving spouse.

Enter the monthly clothing expenses paid by the custodian.

Enter the monthly clothing expenses for the first person for whom an apportionment is claimed.

Enter the monthly clothing expenses for the second person for whom an apportionment is claimed.

Enter the monthly medical expenses paid by the veteran or surviving spouse.

Enter the monthly medical expenses paid by the custodian if claiming expenses on behalf of the claimant(s).

Enter the monthly medical expenses for the first person for whom an apportionment of benefits is being claimed.

Enter the monthly medical expenses for the second person for whom an apportionment of benefits is being claimed.

Enter the monthly amount the veteran or surviving spouse pays for school-related expenses.

Enter the monthly amount the custodial person pays for school-related expenses.

Enter the monthly amount of school-related expenses for the first person for whom an apportionment is being claimed.

Enter the monthly amount of school-related expenses for the second person for whom an apportionment is being claimed.

Enter the monthly amount the veteran or surviving spouse pays for the listed other expense; if none, enter '0'.

Enter the source or brief description of this 'Other Expense' for row 1H (for example, 'child care' or 'transportation'); if you have no expense from this source, enter '0' or 'none'. Fill only if '1H Other Expenses - Veteran or Surviving Spouse' is not '0' or 'none'.

Enter the monthly amount the custodian pays for the listed other expense; if none, enter '0'.

Enter the monthly amount apportioned to the first person for whom apportionment is claimed for this other expense; if none, enter '0'.

Enter the monthly amount apportioned to the second person for whom apportionment is claimed for this other expense; if none, enter '0'.

Enter the monthly amount of this other expense for the veteran or surviving spouse; if none, enter "0" or "none".

Enter the source or brief description of the other monthly expense (for example, insurance, transportation, subscriptions); if there is no expense, enter "0" or "none". Fill only if '1I - Other expenses: Veteran/Surviving Spouse Amount' is not '0' or 'none'.

Enter the monthly amount of this other expense allocated to the custodian; if none, enter "0" or "none".

Enter the monthly amount of this other expense for the first person for whom apportionment is claimed; if none, enter "0" or "none".

Enter the monthly amount of this other expense for the second person for whom apportionment is claimed; if none, enter "0" or "none".

Enter the veteran's full name (first, middle initial, and last) exactly as shown on official records.

Enter the veteran's VA file number or claim number if known; include any letters, dashes, or prefixes exactly as issued.