VBA VA
APPLICATION FOR THE REVIEW OF DISCHARGE OR DISMISSAL FROM THE ARMED FORCES OF THE UNITED STATES (Please read attached instructions before completing this form.) Form Approved OMB No. 0704-0004 Expires Nov 30, 2003 The public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information More
certificate, medical statement of incompetency, must accompany this form.) a. RELATIONSHIP OF INDIVIDUAL SUBMITTING THIS APPLICATION TO ...
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