You only need to complete this form if you have a current partner and are claiming or are in receipt of an income support payment. The Department of Veterans’ Affairs (DVA) needs to know if both members of a couple consent to the collection and sharing of relevant personal and financial information between each member of a couple.

If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.