(DO NOT WRITE IN THIS SPACE) AUTHORIZATION TO …
section i - veteran identification information authorization to disclose information to the department of veterans affairs (va) section iii - information regarding source of record(s) va form jul 2021 21-4142€ supersedes va form 21-4142, mar 2018. omb control no. 2900-0858 respondent burden: 5 minutes expiration date: 07/31/2024. page 1
Form, Identification, Veterans, 1244, Of veterans, 21 4142, Form 21 4142
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OMB Control No. 2900-0406 Respondent Burden: …
www.vba.va.govTO: NAME AND ADDRESS OF LENDER€(Complete mailing address including ZIP Code) FOR VA USE ONLY (Complete in ink) Veteran . is. exempt from funding fee due to entitlement to VA compensation benefits upon discharge from service.
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