Fact Sheet 20-06: Ambulance Transport at VA Expense – A ...

Pay By: Check, Money Order or Credit Card Payable to "VA". Include Account Number. *If paying by Credit Card complete fields marked with an asterisk(*). *CREDIT CARD TYPE *SIGNATURE BALANCE DUE BY AMOUNT DUE *PAYMENT AMOUNT $ AMERICAN EXPRESS MASTER CARD DISCOVER VISA This is where to find your VA account number. ................
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