How To Apply

Complete an official Application for the Persian Gulf Veterans Benefit Program, PG-1 (Short or Long) form. A short form (PG-1 Short) is available for veterans or service persons filing on their own behalf. The long form (PG-1 Long) should be used if you are a surviving family member of a veteran, or if you are applying on behalf of a veteran deemed incompetent. The application must be complete and contain appropriate documentation.

Documents Needed for Submitting Applications:
(Send a COPY of the original document -- documents will not be returned)

• Service Record:
  • For National Guard, Reservists, or Regular Military who are inactive or retired:
    • Certified DD214 (Member 4 Copy) “Certificate of Release or Discharge from Active Duty” or if applicable a DD215 ”Correction to DD214” or other military documents must be provided and must document the following:
      • Receipt of Southwest Asia Service Medal
      • Specific dates of service in, or in support of, the Persian Gulf Theater of Operations
      • Character of Service (DD214 Block 24 – Member 4 Copy) (Note: Recommend applicant provides a Member 4 Copy of their DD214 which displays Character of Service in block 24. Member 1 copy does not provide this information which is required to determine eligibility)
  • For Service Members who are currently on active duty who have not been issued a DD214, the following documentation must be provided:
    • Certified Military Records documenting:
      • Receipt of Southwest Asia Service Medal
      • Specific dates of service in the Persian Gulf Theater of Operations
  • If applicable, documentation to support a name change.
  
  
• Proof of Pennsylvania Residency during period of August 2, 1990-August 31, 1991 (DD214 - block 7b “Home of Record at Time of Entry”), or if Home of Record was somewhere other than Pennsylvania, you must provide one of the following documents:
  • Tax Return (State Income)
  • DoD Leave and Earning Statements
  • Pennsylvania Driver’s License or Identification Card
  • Real Estate Records
  
  
• Proof of Relationship: If you are applying on behalf of a veteran, you must provide proof of your relationship to the veteran.
  • Spouse: Marriage Certificate
  • Child: Birth Certificate for all surviving children
  • Parent: Veteran's Birth Certificate
  • Representative: Proof of authorization to represent
  
  
• Other:
  • Death Certificate, if applicable
  • DD Form 1300 (Report of Casualty)
  • Veterans Affairs Rating Decision, if applicable
  • Application Form

Persian Gulf Conflict Veterans’ Benefit Program
PO Box 1109
Harrisburg, PA 17108-1109
Phone: 1-866-458-9182 (toll free)
TTY: 1-866-835-8983 (toll free number available for hearing impaired)