Utah Department of Veterans and Military Affairs Website

Online Veteran Registration

The Utah Department of Veterans Affairs (UDVA) is committed to improving the lives of Veterans. Any personal information collected by the UDVA will be kept confidential and will only be used for notification regarding Veteran related events and Veterans benefits changes. Statistical data may be collected and used to support the Utah Department of Veterans Affairs mission. No personal information will ever be given out without the prior written approval of the Veteran or their legal representative.

Asterisk * indicates a required field.

*Social Security Number: --
OK to share information with federal VA
Date of Birth: / /
First Name: Middle Name:
Last Name: Suffix:
Gender: Ethnicity:
Street Address
Address 1:
Address 2:
City: State: Zip:
Phone:   --
*Email Address:
                        I Have No Email Address:
I Prefer:
Military Information
Receiving Compensation & Pension Percent of Disability:

Decorations and Medals that may affect potential benefits

Purple Heart
Service Period
Enter your most recent service branch, with or without service dates.
Service Branch:
Service Period:
From: / /
To: / /
Discharge Type:

Utah Department of Veterans and Military Affairs

550 Foothill Drive, Suite 202
Salt Lake City, UT 84113

Phone: (801) 326-2372
Toll Free: (800) 894-9497
Fax: (801) 326-2369
Email: veterans@utah.gov

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