Veterans Affairs | Veteran Claims File Request

To: FOIA / Privacy Act Officer

Agency: Central Office FOIA/Privacy Act Office

Department: Department of Veterans Affairs

FOIA Contact: James P. Horan, Director FOIA
Service (005RIC) Department of
Veterans Affairs 810 Vermont
Avenue, NW Washington, DC 20420

Phone: (202) 632-7233

Re: Name of Veteran: ____________________________

VA Claim Number: _____________________________

Social Security Number: ________-______-__________

Dear Sir:

This is a request for documents under 38 U.S.C. §§ 5701(b)(1) and 5702; 38 C.F.R. §§ 1.525, 1.526, and 1.577 (2011); and the Freedom of Information Act (FOIA), 5 U.S.C. § 552, on behalf of myself,

(Name of Veteran Here) _______________________.

I hereby request a copy of all documents contained in my Veterans Affairs “claims folder”,

to include, but not limited to;

all documents in the right flap,
all documents in the left flap and
all documents in the center flap,
as well as any temporary files including post it notes or any paper clipped additions.

Please forward the copied documents directly to me at the following address:

[Veterans address here]

_________________________ (street address)

_________________________ (city)

_________________________ (state)

_________________________ (zip)

As provided in the FOIA, please respond to this request within 20 (twenty) business-days.

I may be contacted at (Veterans Phone # here) (____) ____-________ if there are any questions.

Thank you for your assistance.

Sincerely,

(Veterans Signature Here) _____________________________