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Get Va 22-8873 1997

ESS INSTRUCTION: Please furnish the information requested in the Item 3 or 4 checked below. Disregard any item not checked. Also furnish any related information that you would like to have considered when VA evaluates your claim. If more space is required, use the back of this form or attach a separate sheet of paper. Be sure to sign and date the form before returning it to VA. 1. FIRST-MIDDLE-LAST NAME OF VETERAN OR ELIGIBLE PERSON 2. VA FILE NUMBER PART I - CHANGE OF PROGRAM 3. YOU HAVE CHAN.

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