Evidence Center
Understand common evidence categories and what they can clarify without treating them as a checklist.
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Buddy and personal statement worksheet
Turn your own observations into a structured statement using VA Form 21-10210's format. This tool does not write your statement for you and does not evaluate what you write.
Official VA Documentation
Official VA Statement Builder
Format sworn personal testimony or third-party lay witness evidence directly into standard VA form schemas.
Section I: Identification
Privacy Safeguard: RatingScope does not collect Social Security numbers, VA file numbers, or dates of birth. Those lines remain blank on your generated statement so you can complete them privately and securely offline.
Section II: Remarks / Sworn Testimony
DEPARTMENT OF VETERANS AFFAIRS
STATEMENT IN SUPPORT OF CLAIM
VA FORM 21-4138 · OMB Control No. 2900-0075
Respondent Burden: 15 Minutes
Expiration: Standard OMB Approved
SECTION I: VETERAN / BENEFICIARY IDENTIFICATION
1. Veteran Name: ______________________________
2. Date of Birth: [Fill offline after printing]
3. VA File / SSN: [Fill offline after printing]
4. Branch of Service: ______________________________
SECTION II: REMARKS (SWORN STATEMENT)
1. In-Service Incurrence & Onset Timeline
(No details entered)
2. Current Symptom Severity & Worst-Day Incapacitation
(No details entered)
3. Occupational & Daily Living Impact
(No details entered)
SECTION III: CERTIFICATION & PENALTY OF PERJURY DECLARATION
I CERTIFY THAT the statements on this form are true and correct to the best of my knowledge and belief. Penalty of Perjury Notice: 18 U.S.C. 1001 provides that whoever knowingly and willfully makes any false, fictitious, or fraudulent statements shall be fined under this title, or imprisoned not more than five years, or both.
Veteran / Claimant Signature
9/26/2026
Date Signed
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