60-Day FRN (2900-0116)

2025-11957, 60-Day FRN (2900-0116, VAF21-4193).pdf

Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution (VA Form 21-4193)

60-Day FRN (2900-0116)

OMB: 2900-0116