VA DATE STAMP (DO NOT WRITE IN THIS SPACE) …
DISABILITIES A. NAME AND LOCATION 13. LIST THE DISABILITY(IES) YOU ARE CLAIMING (If applicable, identify whether a disability is due to a service-connected disability, is due to confinement as a Prisoner of War, is due to exposure to Agent Orange, Asbestos, Mustard Gas, Ionizing Radiation, or Gulf War Environmental …
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INTENT TO FILE A CLAIM FOR COMPENSATION …
www.clientservicesnetwork.comTitle: 21-0966 Author: N. Kessinger Subject: INTENT TO FILE A CLAIM FOR COMPENSATION AND/OR PENSION, OR SURVIVORS PENSION AND/OR DIC (This Form Is Used to Notify VA of Your Intent to File for the General Benefit(s) Checked Below)
Centralized Intake Coversheet - …
www.clientservicesnetwork.comuse this cover sheet to send claim materials to the va claims intake center *** effective january 2017 – please do not use previous versions***. centralized intake coversheet
REQUEST PERTAINING TO MILITARY RECORDS
www.clientservicesnetwork.comStandard Form 180 (Rev. 11/2015) (Page 1) Authorized for local reproduction . Prescribed by NARA (36 CFR 1233.18 (d)) Previous edition unusable OMB No. 3095-0029 Expires 04/30/2018
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