Get VA 21P-0847 2018
providing your E-mail address you provide consent for VA to contact you via E-mail and that those E-mails may contain personal identifiable information. However, VA will never include your SSN in E-mail correspondence.) 12. FAX NUMBER (If applicable) 13. REMARKS 14A. SIGNATURE (Do NOT print) 14B. DATE SIGNED PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or title 38, Code of Fe.
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