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
Complete applications with attachments should be mailed to:
Persian Gulf Conflict Veterans Benefit Program
Bldg. 0-47, Fort Indiantown Gap
Annville, PA 17003
Phone: 1-866-458-9182 (toll free)