RANK 4C. DATE OF INJURY/DEATH Mo. day yr. 4E. UNIT ASSIGNMENT DURING INCIDENT Such as DIVISION WING BATTALION INJURED NON-BATTLE VA FORM OCT 2007 21-0781 EXISTING STOCKS OF VA FORM 21-0781 JUL 2004 WILL BE USED. BATTALION CAVALRY SHIP 9. REMARKS I certify that the foregoing statement s are true and correct to the best of my knowledge and belief. 10. SIGNATURE 11. DATE 12. TELEPHONE NUMBERS Include Area Code...
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