VA Form 29-0975e ( Authorization to Disclose Personal Information to a Thir

Authorization to Disclose Information to a Third Party (Insurance) (VA Forms 29-0975 & 29-0975e)

29-0975e (DocuSign)(1-9-24)

AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE)

OMB: 2900-0856