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Get Va 21-4192 1994

EFITS SECTION I - IDENTIFICATION INFORMATION (To be completed by VA) . 1. NAME AND ADDRESS OF EMPLOYER OF VETERAN (Complete) . 2. ADDRESS (Complete) RETURN TO INSTRUCTIONS: The veteran named in Item 3 has filed a claim for veterans disability benefits and has stated that he/she was recently employed by you. In order to arrive at a fair decision in this case, we need the information requested below. Please complete Sections II and III and return to this office at the above address. Please b.

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