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Lake County, Ohio USA

Veterans Service Office

An Office of the Lake County Government

Veterans Serving Veterans

Providing Assistance to the Men and Women who have Honorably Served Their Country
Lake County Home Page Veterans Home Page Mission Statement How Can We Help You Benefits News/Newsletters Financial Assistance Transportation Data Record Links

Veterans Data Record

There is a Veterans Service Office in each county in the state of Ohio. We are at your service to help develop and file claims and assist you and your dependents in applying for the various benefits you may be entitled to. It is recommended that you list numbers and locations of the following noted items so that your family will have the details necessary to file for benefits if you are incapacitated or deceased.

You should fill out this form, print and file it in a safe place at home and summit it to your local Veterans Service Office for safekeeping. 

Your Information
* Required Fields
Full Name: * Home Address: * Home Phone *
Email Address: * Date of Birth: *
Dates of Service: * Branch of Service: * Service Number:
DD214 on file at: Discharge Recorded at: Type of Discharge:
VA Claim Number: Place of Birth:*

Spouse's Information
Spouse's Full Name: Maiden Name: Birth Date:
Date and Place Married: Where did you get your Marriage License?:

Childern's Information
Childern's Name:         Date of Birth: Place of Birth:

Please Enter Your Comments Here


 

You have earned the right to certain veterans benefits. Use this form to make it easier for your family in case of emergency. Print a copy for yourself and Submit this Form to the Lake County Veterans Service Office by Pressing the Submit Form Button above.