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Appointment of Appeal Representative and Authorization to Disclose Information

Designates a representative for the Appeals process only.

 The information that you are asked to provide on the form is as follows. You must have this information available to complete the form properly.

  • Your name, signature and date
  • The name of the person that you are authorizing for the appeals process
  • Your sponsor number (the social security number of the family member who served)

 

Appointment of Appeal Representative.pdf | 86 KB

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