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Champva fax number Form: What You Should Know

You will need to fill out CHAM PVA Application for Benefits, VA Form 10-10d, and provide the additional information in order to receive CHAM PVA benefits.  1) If you have any outstanding claims from the VA, submit them by mail to CHAM PVA, ATTN: Eligibility Unit, PO Box 469028, Denver, CO 80.  2) The remaining documentation for your coverage should be sent to CHAM PVA, Attn: Eligibility Unit, PO Box 469028, Denver, CO 80.  3) If you have enrolled in CHAM PVA, apply and complete CHAM PVA Claim Form, and send to the address on the front. 2, 3) CHAM PVA Application for Benefits, VA Form 10-10c: Claim and Information — Military Caregiver Coverage or CHAM PPA The information provided in this application form must cover the following: The last 4 digits of your social security numbers; Your service branch; Your marital status; Your dependents. NOTE: If you are filing on behalf of a dependent child under 19 years of age, the same information should be provided on the application form for each child who is under 19 years of age. The dependent child does not count toward the 20 dependent children maximum.  Your military caregiver, and how this person  provided for your care of the Department of Veterans Affairs in the past. NOTE: If you are eligible for a CHAM PVA insurance program, you must include information to be included in order to be eligible on this application form. See the CHAM PVA Information for the Applicant, below. 1) Your military caregiver, if applicable. If applicable, you must list for this type of benefits the name of the caregiver who provides your care in the past. For example, you are a caregiver of: Your spouse; Your partner; Your child; Your parent; Your sibling; Any other person you named in your military care order or waiver (such as a dependent child); or All of the above. The information you enter for this category on the application for benefits will help the VA determine whether you are an eligible person to receive service branch CHAM PVA insurance benefits.

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