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

ICR 202401-2900-003

OMB: 2900-0856

Federal Form Document

Forms and Documents

Document Name	Status
Form VA Form 29-0975 AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE) Form	Modified
SupportState(2900-0856).docx Supporting Statement A	2024-03-15
2024-05553.pdf Supplementary Document	2024-03-15
2024-00494.pdf Supplementary Document	2024-01-24

IC Document Collections

IC ID	Document Title	Status
220731	AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY (INSURANCE) Form	Modified