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VA Form 10-0491D Printable, Fillable in PDF – The VA is asking you to provide the information on this form under the authority of 38 U.S.C. §7501 (VIOMPSP), §7611 (HPSP), and §7601 (VHVMAESP) in order for VA to administer your scholarship award. VA may disclose the information that you put on the form as permitted by law. VA may make a “routine use” disclosure of the information for civil or criminal law enforcement; congressional communications; the collection of money owed to the United States; litigation in which the United States is a party or has an interest; the administration of VA training and scholarship programs, including verification of your eligibility to participate; and personnel administration.
You do not have to provide this information to VA but, if you do not, VA may be unable to initiate the placement process to ensure service obligation completion. If you give VA your social security number, VA will use it to obtain information relevant to administering your scholarship award. It also may be used for other purposes.