USVSST Fund Forms

All claimants should use the new and updated forms linked on this page, which list an expiration date of January 31, 2026. Please do not submit earlier versions of these forms to the USVSST Fund.

The following documents are in PDF format


USVSST Fund Application Form

Forms
Change of Attorney Form
Applicant’s Acknowledgment of Statutory Limitation on Attorneys’ Fees
Attorney’s Certification of Compliance with Statutory Limitation on Attorneys’ Fees
Authorization for Communication
Hearing Request Form
Informer Information and Acknowledgement
ACH Payment Form

This form is only for claimants notified by the Special Master that they are eligible and authorized to receive payments. These claimants must complete this form in order to receive their award amount by direct deposit.

Forms for Personal Representatives of Deceased Individuals
Certification of Personal Representative
Notice of Filing Claim - The Personal Representative must notify everyone specified in Part VII.2 of the Notice published in the Federal Register. Use of this particular Notice of Filing Claim form is not required; however, any other notification must meet all of the requirements in Part VII.2.

These documents are in PDF format. Acrobat Reader is required to view PDFs. You may already have the Adobe Acrobat Reader on your computer or on disks that came with your computer. If you do, you won't need to download Adobe Acrobat. If you do not have Acrobat, you may download the Free Adobe Acrobat Reader.