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U.S. DOD Form dod-va-21-601 OMB Approved No 2900-0216 Respondent Burden 30 minutes APPLICATION FOR REIMBURSEMENT FROM ACCRUED AMOUNTS DUE A DECEASED BENEFICIARY IMPORTANT Read instructions on reverse
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The US DoD Form DoD-VA-21-601 is a form used for reporting injuries and illnesses that occur in the line of duty for members of the Armed Forces.
Active Duty Service Members are required to file the US DoD Form DoD-VA-21-601 if they suffer from an injury or illness that occurred in the line of duty.
To fill out the US DoD Form DoD-VA-21-601, you need to provide information about the injury or illness, including the date it occurred, the circumstances, and any treatment received.
The purpose of the US DoD Form DoD-VA-21-601 is to report injuries and illnesses that occur in the line of duty, so that the servicemember can receive appropriate medical treatment and benefits.
The US DoD Form DoD-VA-21-601 requires information such as the servicemember's name, rank, unit, and contact information, as well as details about the injury or illness and any treatment received.
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