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10-5345. VA FORM. JUN 2017. Page 1 of 2. LAST 4 SSN. LAST NAME- FIRST NAME- MIDDLE INITIAL. PRIVACY ACT INFORMATION: The execution of this form does not authorize the release of information other than that specifically described below. The information requested on this form is solicited under Title 38 U.S.C.
VA Form 10-5345. Search VA Forms · Request For and Authorization To Release Medical Records Or Health Information File Type: PDF Issue Date: 11/29/2004. Revision Date: 08/2017. Total Pages: 1. If you are unable to find your form here, you may want to visit: Request for DD 214 or other Military Records NARA SF 180
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Results 1 - 9 of 9 SUPERSEDES VA FORM 24-0296, NOV 2009,. WHICH WILL NOT BE USED. 21 Aug 2005 VA 10-5345 - (Current as of Mar 2003, includes HIPAA statement) (Request No # Florida Department of Education - Florida Scholarships for Children of Deceased 27-8944 Instructions for Applying for Aid
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