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Inside the box I hereby authorize release of the, (If signed by other than veteran, DATE OF REQUEST:, (name) (street number) (city), Daytime Phone No, Date, Prepared by, AFN-M, NATIONAL PERSONNEL RECORDS CENTER, NATIONAL ARCHIVES AND RECORDS, and NA FORM 13055 (Page 1 of 2) (REV type in the details that the software requests you to do.
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