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Get and Sign Va Form 28 8861
Either requires a leave of absence or makes training or employment questionable,
include this information in item 16.
1. FIRST - MIDDLE - LAST NAME OF VETERAN
2. TELEPHONE NUMBER (Include Area Code)
3. SOCIAL SECURITY
NUMBER
TRA2. ADDRESS OF VETERAN
5. SERVICE DATES (Mo., day, yr.)
6. VA FILE NUMBER
FROM
TO
7. DOB (Mo., day, yr.)
8. REHABILITATION OBJECTIVE OF VETERAN
9. ANTICIPATED DATE OF REHABILITATION
10A. SERVICE-CONNECTED DISABILITIES
10B. COMBINED SERVICE-CONNECTED...
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