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Enter the requested data in the space CHECK APPROPRIATE BOX ADD DELETE, NAME OF FUNCTIONAL TASK CODES, DEFINE LEVEL OF ACCESS REQUESTED, A REQUESTING OFFICIAL TITLE, C APPROVING OFFICIAL TITLE, E SECOND APPROVING OFFICIAL TITLE, SIGNATURES, BDATE, D DATE, and F DATE.
You can be asked for particular significant particulars if you would like complete the E SECOND APPROVING OFFICIAL TITLE, G NAME AND TITLE OF FACILITY POINT, F DATE, G DATE, VA FORM DEC, and All prior editions of VA Form are segment.
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