Do you Qualify for Veteran's Aid and Attendance

Are you a veteran or the spouse of a veteran of the US Armed Services (Army, Navy, Air Force, Marines, Coast Guard or Merchant Marines)? *

Yes No

During which of the following periods did you or your spouse serve? *

World War II ( December 7, 1941, through December 31, 1946) Korean Conflict (June 27, 1950, through January 31, 1955) Vietnam Era (February 28, 1961, through May 7, 1975) Persian Gulf War (August 2, 1990, through not yet determined) Other (any other time period)

Did you serve on active duty during any of the time you were in the military?

Yes No

How many days did you serve on active duty? *

Are you age 65 or older, a spouse or fully disabled? *

Yes No Spouse Fully Disabled (As determined by Social Security Administration)

Spouses need not be age 65 to qualify. Additionally if you are fully disabled as determined by the Social Security Administration, you may qualify.

Are you able to drive an automobile? *

Yes No

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