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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 488 (January 27, 2024).

43 Pa. Code § 5.4. Application procedures.

§ 5.4. Application procedures.

 (a)  Forms. An application for Veterans’ Emergency Assistance and requests for renewals of assistance payments shall be made on forms prescribed by the Department.

 (b)  Source of forms. Application forms may be obtained from:

   (1)  The County Directors of Veterans’ Affairs.

   (2)  The Service Officers for Veterans’ Organizations.

   (3)  The case workers for the American Red Cross.

   (4)  The Adjutant General’s Offices in Pittsburgh, Philadelphia and Wilkes-Barre.

 (c)  Completion of forms. An applicant for Veterans’ Emergency Assistance shall complete and sign the application form and verify, under penalty of law, that the information submitted in support of the application is true and correct to the best of the applicant’s knowledge and belief. If the applicant is unable to sign the application due to a medical condition, the spouse or legal guardian may sign the application for him.

 (d)  Submission of forms. An application form shall be submitted through one of the offices named in subsection (b). The official submitting the application will review it to verify its completeness and accuracy. The following documents shall be submitted with the application:

   (1)  Veteran’s DD-214 or Report of Separation from active military service.

   (2)  For widows and widowers, a copy of the applicant’s marriage license and veteran’s death certificate.

   (3)  A copy of a birth certificate of the veteran’s dependent children and, if applicable, a copy of court orders indicating payment of child support.

   (4)  Proof of residency by the veteran’s tax record, employment record, voting registration or a copy of a driver’s license.

   (5)  Proof of loss of employment, if applicable, including the applicant’s termination notice from employment.

   (6)  Proof of other benefits, including, if applicable, unemployment compensation, Bureau educational benefits, Bureau disability compensation/pension, social security or Federal, state or local pensions, public welfare, union benefits, Social Security Income, workmen’s compensation or insurance (sick benefits).

   (7)  Proof of lack of other income, including, if applicable, employment pay and allowances, annual or sick leave, income from rental of property, savings, financial assistance provided by family and friends, and interest and dividends.

   (8)  Receipts indicating current monthly mortgage, rent and utility payments.

 (e)  Mailing address. Application forms shall be sent to the Bureau for Veterans’ Affairs, Department of Military Affairs, Fort Indiantown Gap, Annville, Pennsylvania 17003-5002.


   The provisions of this §  5.4 issued under the Military Code, 51 Pa.C.S. §  1704(7).


   The provisions of this §  5.4 adopted August 23, 1991, effective August 24, 1991, 21 Pa.B. 3813.

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