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PRIVACY ACT RELEASE FORM Veterans/Active Duty Military Casework This form must be completed by the veteran /service member Federal agencies are prohibited from releasing information concerning an individual to a third party under the Privacy Act of 1974. Please complete and sign this form which will allow information regarding your concern to be released to the office of Senator Barbara A. Mikulski. Name of Veteran/Service Member Date of birth VA Claim Number Social Security Number MD...
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How to fill out Privacy Act Release Form VeteransActive Duty

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How to fill out Privacy Act Release Form Veterans/Active Duty Military

01
Obtain the Privacy Act Release Form from the relevant military or veterans’ administration website or office.
02
Fill in your personal information, including your full name, Social Security number, and date of birth.
03
Indicate the purpose of the release, detailing what information you wish to be released and to whom.
04
Sign and date the form to authorize the release of your information.
05
Submit the completed form to the appropriate agency or office as instructed.

Who needs Privacy Act Release Form Veterans/Active Duty Military?

01
Veterans seeking to access their military records or benefits.
02
Active duty military personnel requesting the release of their personal information.
03
Family members or representatives of veterans or active duty members who need to obtain records on their behalf.
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The Privacy Act Release Form for Veterans and Active Duty Military is a document that allows individuals to authorize the release of their personal information held by the Department of Veterans Affairs (VA) or other military institutions.
Any veteran or active duty military member who wishes to permit the release of their medical records, service records, or other personal information to a third party must file this form.
To fill out the form, individuals must provide their personal details, such as name, Social Security number, and contact information, along with the details of the person or entity to whom the information should be released, and specify what information is being released.
The purpose of the Privacy Act Release Form is to ensure that veterans and active duty military members can control the dissemination of their personal information, thus protecting their privacy rights under the Privacy Act.
The form requires the individual's full name, Social Security number, date of birth, contact information, the name of the person or organization receiving the information, and a description of the information being released.
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