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Get VA 21-0845 2010

(Continued on reverse) OMB Approved No. 2900-0736 Respondent Burden: 5 minutes (DO NOT WRITE IN THIS SPACE) (VA DATE STAMP) AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY INSTRUCTIONS: Use this form if you want to give the Department of Veterans Affairs permission to release your personal beneficiary or claim information to a third party. This form may not be executed by any beneficiary recognized as incompetent for VA purposes, nor can VA accept this form from any benefic.

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