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Fillable VA FORM 21 - 4718a - Veterans Benefits Administration - vba va

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OMB APPROVED NO. 2900-0017 RESPONDENT BURDEN: 3 Minutes CERTIFICATE OF BALANCE ON DEPOSIT AND AUTHORIZATION TO DISCLOSE FINANCIAL RECORDS (Pursuant to Title 38, U.S.C., Chapter 55 and Title 12, U.S.C., Chapter 35) NOTE: PLEASE READ THE INSTRUCTIONS ON THE REVERSE BEFORE COMPLETING THE FORM. PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any source other than what has been...
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