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Get Authority To Release And Ship Effects And Funds

U.S. DOD Form dod-va-2064 AUTHORITY TO RELEASE AND SHIP EFFECTS AND FUNDS NAME Check distribution CHIEF FINANCE FISCAL DIVISION DATE OF BENEFICIARY S DEATH PATIENTS CLOTHING AND VALUABLES CUSTODIAN CHIEF SUPPLY DIVISION DATE SHIPPED Divided CLAIM NO. SOCIAL SECURITY NO. XC RELEASE AND SHIP DELIVER EFFECTS OR FUNDS TO NAME OF RECIPIENT Specify relationship and whether designee or alternate ADDRESS In accordance with Regulations you are authorized to release and ship to the recipient indicated the personal effects and/or the unencumbered balance of funds on deposit in PERSONAL FUNDS OF PATIENTS to the credit of the above deceased beneficiary. Shipment of personal effects at Government expense shall not exceed 25. Transfer of these effects and/or funds covers possession only and such tranfer does not in itself affect title thereto. If contested payee will be accountable to the owner of said effects and/or funds under the applicable laws. SOCIAL SECURITY NO. XC RELEASE AND SHIP DELIVER EFFECTS OR FUNDS TO NAME OF RECIPIENT Specify relationship and whether designee or alternate ADDRESS In accordance with Regulations you are authorized to release and ship to the recipient indicated the personal effects and/or the unencumbered balance of funds on deposit in PERSONAL FUNDS OF PATIENTS to the credit of the above deceased beneficiary. Shipment of personal effects at Government expense shall not exceed 25. Transfer of these effects and/or funds covers possession only and such tranfer does not in itself affect title thereto. Shipment of personal effects at Government expense shall not exceed 25. Transfer of these effects and/or funds covers possession only and such tranfer does not in itself affect title thereto. If contested payee will be accountable to the owner of said effects and/or funds under the applicable laws. SOCIAL SECURITY NO. XC RELEASE AND SHIP DELIVER EFFECTS OR FUNDS TO NAME OF RECIPIENT Specify relationship and whether designee or alternate ADDRESS In accordance with Regulations you are authorized to release and ship to the recipient indicated the personal effects and/or the unencumbered balance of funds on deposit in PERSONAL FUNDS OF PATIENTS to the credit of the above deceased beneficiary. Shipment of personal effects at Government expense shall not exceed 25. Transfer of these effects and/or funds covers possession only and such tranfer does not in itself affect title thereto. If contested payee will be accountable to the owner of said effects and/or funds under the applicable laws.

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