Petition for Extraordinary Relief Form

• Legal Form Number: 5
• Court: United States Court of Appeals For Veterans Claims
• Section: Court of Appeals for Veteran Claims

1

Redact all Social Security numbers, dates of birth, financial account numbers, and name(s) of any minor child(ren).

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS (CAVC)

INSTRUCTIONS

A petition for extraordinary relief is a written request for specific action that you want the Court to take

to resolve your situation.

Your petition must (1) clearly explain your situation, (2) state what relief you are requesting, that is,

what you want the Court to do for you, (3) provide all the important facts necessary for the Court to

fully understand the situation, and (4) attach copies of any order, decision or any other documents

necessary to understand and support the petition.

A. Fill Out Pages 2-4: Your petition may be typed or legibly handwritten. You may add extra pages as

necessary (see paragraph B below).

B. Length: Petitions may not exceed 20 pages. You may include relevant attachments to your petition. These

attachments are not counted against the 20-page limit.

C. Signature: You must sign your petition (see page 4).

D. How To File: You may file a petition by (pick one option):

(1) emailing it to self-rep@uscourts.cavc.gov; or

(2) faxing it to (202) 501-5848; or

(3) mailing it to Clerk, U.S. Court of Appeals for Veterans Claims, 625 Indiana Avenue, NW, Suite 900,

Washington, DC 20004-2950

E. How To Contact You: Initial below if you want the Court to send all petition-related documents to your

email instead of by U.S. mail. Place your initials here: _______ If you do not initial this form, the Court will

mail all petition-related documents to your mailing address.

F. Payment of Fees: There is a $50 filing fee for a petition. Please wait to pay until you have received

your CAVC case number. You may pay through pay.gov (http://www.uscourts.cavc.gov/fee_filingfee.php)

or you may send a check or money order, payable to “US Court of Appeals for Veterans Claims.” DO NOT

SEND CASH. If you are eligible, you may request a waiver of the filing fee by emailing, faxing, or

mailing the Court a completed Form 4 (Declaration of Financial Hardship), available at

http://www.uscourts.cavc.gov/documents/Form_4.pdf.

G. Action on the Petition: If your petition complies with these procedures, the Clerk will file your petition.

H. Accessing Your Case: Once you have received your CAVC case number, you can access your case by going

to the CAVC home page at http://www.uscourts.cavc.gov and selecting “Docket Search.”

I. Privacy: Pursuant to Rule 6, and to protect your privacy, any documents you submit with a VA claims

file number or other personal identifier (such as Social Security number, date of birth, financial account number,

name of minor child) must be redacted. Redact sensitive personal information by removing, obscuring, or

blackening out the personal information.