Fillable 21P - 8416 INSTRUCTIONS FOR MEDICAL EXPENSE REPORT - vba va
Reginfo. gov/public/do/PRAMain. If desired you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form. VA FORM FEB 2012 21P-8416 SUPERSEDES VA FORM 21P-8416 DEC 2011 WHICH WILL NOT BE USED. I certify that the above information is true. 22A. SIGNATURE OF CLAIMANT Do NOT print 22B. DATE PENALTY The law provides severe penalties which include fine or imprisonment or both...
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