STATE APPLICATION FOR INTERMENT ALLOWANCE (UNDER …
I HEREBY CERTIFY THAT the veteran named in Item 1 was buried in a State-owned Veterans Cemetery (without charge). 17C. DATE SIGNED 17A. SIGNATURE OF STATE OFFICIAL DELEGATED RESPONSIBILITY TO APPLY FOR FEDERAL FUNDS (Sign in ink) VA FORM 21P-530a, DEC 2019. Page 2. SECTION IV:€CERTIFICATION AND SIGNATURE. 17B.
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