Servicemembers Civil Relief Act (SCRA) Request for Benefits

Please complete the required fields below to initiate a request for benefits. We will use the information you provide to determine Servicemember Civil Relief Act (SCRA) eligibility on any accounts that you have with Capital One. If eligible, we will send an enrollment letter to the address associated with your account detailing your benefits. Please allow up to sixty days for receipt of this letter.

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About the Servicemember:

Customer Acknowledgement:

To facilitate enrollment, Capital One has developed this form as a method of taking SCRA benefit requests from servicemembers for their Capital One accounts. Capital One will use the information you provide on this form to verify your eligibility for SCRA benefits, including contacting the Department of Defense's Defense Manpower Data Center (DMDC). This channel is available to servicemembers only. If you are not a servicemember but believe you are due benefits please use one of our other available channels as explained on the previous page to submit your request.