VA Form 21-4192 help needed

[stovokore]

I'm having some trouble understanding the 21-4192 document,

in section 1 it says in parenthesis (to be completed by VA) 

and below that it has address blocks 1 and 2 (and the word "complete" in parentheses) 

Pretty sure my former employer's information goes into block one (filled out by me?) 

but i'm not sure what goes in block 2 - It says "return to" between the blocks. 

Thanks for any assistance you can give. 

Edited October 18, 2017 by stovokore

[broncovet]

Good question. 

When I looked up this form online, it was strangely absent.  My guess:  This form is no longer used, but that is a guess.  Can you call your VSO and ask him?  Try an IRIS inquiry.  Or maybe someone else can chime in.  

[stovokore]

6 hours ago, broncovet said:

Good question. 

When I looked up this form online, it was strangely absent.  My guess:  This form is no longer used, but that is a guess.  Can you call your VSO and ask him?  Try an IRIS inquiry.  Or maybe someone else can chime in.  

Thanks for responding. I'v re read my comment and I see now that I made a typo regarding the form number. Its actually 21-4192 (not 21-4129)  

http://www.nd.gov/veterans/files/resource/21-4192.pdf is where you can find an example of the document. 

Iv thought about seeking a VSO and asking him but they are difficult to track down in the small town I live in. 

Thanks for any advice you can give me, iv got about 25 days left to complete the form and upload it to ebenefits 

[broncovet]

I agree its confusing.   This is the form sent to your employer for him to fill, sign and return.  This was not done THIS way, when I applied.  

I have 2 suggestions:

1.  Put the name of the employer, and the employer address in the applicable box, even if it says to be filled out by VA, after all, why would the VA know who you worked for, unless you told them.  

2.  If you dont like that idea, you can ask a VSO, who is supposed to do this stuff everyday.

[stovokore]

Thanks, those are good ideas. Just kinda confused about what goes in block 2 and why it says "return to"  between blocks 1 and 2 

[broncovet]

The form is sent to your employer for verification, then its supposed to be returned by your employer to VA.  Hope this helps.