AUTHORIZATION TO DISCLOSE INFORMATION
States, and some individual sources of information, require that the authorization specifically name the source that you authorize to release personal information. In those cases, we may ask you to sign one authorization for each source and we may contact you again if we need you to sign more authorizations.
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(DO NOT WRITE IN THIS SPACE) AUTHORIZATION TO …
www.vba.va.govsources with information about you to release that information if you sign a single authorization to release all your information from all possible sources. We will make copies of it for each source. A few States, and some individual sources of information, require that the authorization specifically name the source that you authorize to