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VA FORM 21P-534a - Veterans Benefits Administration

NOTE: When you file this application, you are telling us that you elect to receive Dependency and Indemnity Compensation (DIC) and all other service-connected death benefits to which you and/or the deceased veteran's children may be entitled. PLACE OF BIRTH (City and State) 1. VETERAN'S NAME (First - Middle Initial - Last) 2.

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  Administration, Applications, Benefits, Death, Veterans, Veterans benefits administration, Death benefits

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