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Get VA MATIC ENROLLMENT/CHANGE - Vba Va

OF INSURED SECTION I - TO BE COMPLETED BY INSURED 2. INSURANCE FILE NUMBER 3. SOCIAL SECURITY NUMBER 4. DAYTIME TELEPHONE NUMBER I HEREBY authorize the Department of Veterans Affairs to start/change a deduction from my account at the financial institution stated below for the purpose of paying Government Life Insurance premiums. I further authorize the Department of Veterans Affairs to adjust the amount of this deduction if my premiums increase or decrease. I understand that each deduction.

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