Military/Discharge Documents: VA recommends that you attach photocopies of readily available supporting documents so that we can make the determination quickly. Documents may include the most recent discharge document (DD Form 214) showing active duty service records other than for training purposes, or active duty for a minimum of 24 continuous months for enlisted Servicemembers after September 7, 1980; for officers, after October 16, 1981, or the full period for which the person was called to active duty. If you are unable to locate copies of military records, apply anyway, as VA will attempt to obtain records necessary to make a determination.
Name of Veteran: DO NOT include nicknames, military rank or civilian title(s
Name and Mailing Address of Person Requesting Certificate: Provide the full name and complete mailing address to avoid delays in delivery.
We strongly recommend you complete this form online (http://www.cem.va.gov/pmc.asp) and print and sign before you submit your request.
Complete a new VA Form 40-0247 for each additional address where certificates will be mailed to.
Privacy Act Information: VA considers the responses you submit confidential (38 U.S.C. 5701 VA may only disclose this information outside the VA if the disclosure is authorized under the Privacy Act, including the routine uses identified in the VA system of records, 175VA41A published in the Federal Register.