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Tion and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. Valid OMB control numbers can be located on the OMB Internet page at www.reginfo.gov/public/do/PRAMain If desired, you may call 1-800-827-1000 to get information on where to send comments or suggestions about this form. 1. FIRST - MIDDLE - LAST NAME OF VETERAN 2. ARE YOU MARRIED? YES 3A. DATE OF MARRIAGE (Month, day, year) 3B. PLACE OF MARRIAGE (City, State) 3.

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