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Va direct deposit 1199a Form: What You Should Know

The claim number and type of payment are printed on Government checks. Please note that you will be responsible for keeping the claim numbers and types of payments on the forms. The number you enter into this form should match the numbers you use for your check writing and payment record keeping systems. If you have any questions about the direct deposit system or the format of these form, please phone the Customer Service Center at. Standard Forms 4 and 5 for Payments Directed to Individual Service members, Veterans, and their Family Members — SF 46.1 and SF 46.2 Each form will ask for details about payment, a claim number and type of payment to be provided by direct deposit, and a name and address you will include in your own federal claim for disability compensation or pension. To read the back of both forms, click on SF 46.1 and SF 46.2. The claims number and type of payment are printed on each form. Please make sure you check the check signature box and enter your name using the corresponding number. The forms need to be completed to receive a claim number. If the check number you enter does not match the number on your claim, you will need to make an additional claim for the claim number. Note: You will then need to enter the original claim number you have on file in your claim as well as the new number. If you would rather receive a paper copy for your records, please give us a phone number to which you can send an SSA form. The following information will be entered on the forms: Payee's Social Security Number Dependent's Name and Age Dependent's Address Payment Type (Government Check, Federal Direct Deposit, or a Check for a Private Payment) Receipt for the payment and proof of payment Date and time of the payment Number of payment and date of discharge (if applicable) Payment Number Receipt Number Signature Copy of Your Birth Certificate The complete SF 46.1 and SF 46.2 can be downloaded as a .pdf or .txt file in the attachment of this document. If you preferred a paper copy for your records, please include that in the payment for your claims.

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