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Va 21-4142 mar 2021-2024 Form: What You Should Know

VETERANS AFFAIRS. VB: I consent to the use of my personal information for the purposes described on my form. I understand my information may be disclosed to non-VA sources. For more information, contact Legal Help For Veterans , toll-free in the continental United States (toll-free US & Canada only) at or through the Internet at: Website: (This page is temporarily nonfunctioning) Legal Assistance & Disability Rights Legal Services, Inc. PO Box 47225 Greensboro, NC 27 919.723.2826 or 888.736.1786 Email us at legalhelp-for-veterans-at-vmnt.com If you are viewing this page via a mobile device, please click the button to download the document to your device and view it on your browser. (There may be a delay to load the document.) Please sign and date the form on page two, then complete the Disclaimer and Release Form, which must be signed and dated on page two.

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