Planning Your Legacy
VA Survivors and Burial Benefits

Our Mission: To fulfill President Lincoln’s promise to carefor those who have served in our nation’s military and fortheir families, caregivers, and survivors.

Introduction
The Department of Veterans Affairs (V A) offers this survivors and burial benefits kit as a source of
pre-need planning information and record storage for Veterans and their families. This kit isintended to be used as a supplement to the Summary of VA Dependents’ and Survivors’ Benefits
pamphlet1.
Included you will find a section entitled Planning for the Future to guide you through end-of-lifeand survivors’ benefits eligibility. This section will tell you what benefits are offered and whenand how you should apply.
For your convenience, we have provided space for you to add your own personal informationthat can be kept in a centralized location for your use, and for the use of loved ones. This
Record of Personal Affairs section identifies the location of important documents, accountnumbers, military discharge documents, and marital information.
Additionally, we have provided samples of completed forms that may be needed in theapplication process. VA forms change periodically; current versions can be found online atwww.va.gov/vaforms.
It is our sincere desire that the information and documents contained in this brochure assist you
and your loved ones.
On behalf of a grateful nation, we respectfully thank all Veterans for their service.

Honor is not a word,
but a way of life.

1

https://benefits.va.gov/BENEFITS/benefits-summary/SummaryofVADependentsandSurvivorsBenefits.pdf

2 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

Planning for the Future
VA has benefits designed to aid you and your family in preparing for the future. The documentsin this packet will help guide you and your loved ones as you plan, and ensure your survivors
know what benefits are available to them.
The following benefits are available to Veterans and their families:

Pre-Need Eligibility for National Cemetery Burial or Memorialization
VA provides for a final resting place for eligible Veterans, spouses, and their eligible
dependents, as well as a headstone or marker, a flag to drape the casket, and a Presidential
Memorial Certificate.

Memorial or Burial Flags
A United States flag is provided at no cost, to drape the casket or accompany the urn foreach family of an eligible deceased Veteran in the U. S. Armed Forces. U.S. Post Offices are
the primary issuing point for burial flags. Each family of a decedent is entitled to one flag.

Government Headstones or Markers
VA can provide a single headstone, columbarium niche cover, or a flat marker for a
Veteran’s final resting place (private, state, or national cemeteries).

Cemetery Medallions
VA can provide a medallion for use on a headstone or other memorial in a private cemeteryto signify a decedent’s status as Veteran. Multiple sizes are available.

Presidential Memorial Certificates
VA can provide a Presidential Memorial Certificate (PMC) to the family of the deceased
Veteran. A PMC is an engraved paper certificate signed by the current President.

Burial Benefits and Burial Automatic Payments
Burial benefits are paid to a spouse, designated family member, or executor to partially
offset the cost of burial expenses, plot costs, and transportation costs for a Veteran’s
remains. These benefits are paid at different rates based on whether the Veteran’s death
was service-connected or non-service connected.
If the Veteran was receiving VA benefits prior to passing and had a spouse of record, thesebenefits will usually be paid automatically to that spouse. However, if someone other than
the spouse paid for the burial and submitted an application, additional benefits, including aplot or interment allowance and transportation allowance, may also be payable.
An application for non-service-connected burial benefits must be submitted within two
years from the date of death. There is no time limit for a service-connected death.
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Dependency and Indemnity Compensation
Dependency and Indemnity Compensation (DIC) is a monthly tax-free benefit provided to aneligible surviving spouse, dependent child/children, and/or the parent/parents of a Service
member who died while on active duty, active duty for training, inactive duty training, or tosurvivors of Veterans who died from service-connected disability/disabilities.
DIC benefits paid to surviving spouses and children are not income based. Parents DIC is an
income-based benefit for parents who were financially dependent on a Service member or
Veteran who died from a service-related cause.
On August 10, 2022, President Biden signed the Sergeant First Class (SFC) Heath Robinson
Honoring our Promise to Address Comprehensive Toxics Act of 2022, also known as the
PACT Act, into law. This law increases eligibility for benefits by expanding lists of locations,timeframes, and presumptive conditions related to toxic exposure(s) experienced by
Veterans. Survivors may qualify for expanded eligibility for Dependency and Indemnity
Compensation (DIC). Please see www.va.gov for additional information on the PACT Act.

Dependents’ Educational Assistance Program
The Dependents’ Educational Assistance Program offers education and training
opportunities to eligible dependents, including dependents of Veterans who arepermanently and totally disabled due to a service-related condition, dependents of Service
members who died during active military service, or dependents of Veterans who died as aresult of a service-related condition.

Marine Gunnery Sergeant John David Fry Scholarship
The Marine Gunnery Sergeant John David Fry Scholarship provides eligible beneficiaries
with financial support for tuition and fees, books and supplies, and housing. You may be
eligible for up to 36 months of Fry Scholarship benefits if you are the surviving spouse or
child of a Service member who died during active duty after September 10, 2001. If you are
the child of the Service member, you must use your benefits between your 18th and 33rdbirthdays, and you may still be eligible if you are married. If you are the surviving spouseand you remarry, you will no longer be eligible.
The 15-year time limitation for using Post-9/11 GI Bill benefits is eliminated for qualifying
dependents (Fry children who became eligible on or after January 1, 2013, and all Fry
spouses).

Survivors Pension
A tax-free monetary benefit payment to a low-income, un-remarried surviving spouse
and/or eligible unmarried child/children of a deceased wartime Veteran, whose death is notservice-related. Certain deductible expenses, such as an unreimbursed medical expense,
may be used to reduce the survivor’s countable income.

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Special Monthly Pension Benefits
The Special Monthly Pension Benefits are additional funds allocated for certain survivors
who are eligible for VA pension benefits and require the aid and attendance of anotherperson, or are housebound, may be eligible for additional monetary payment. Thesebenefits are in addition to monthly pension, and they are not paid without eligibility to
Pension.

The Civilian Health and Medical Program of the Department of Veterans Affairs
A program that provides reimbursement for some medical expenses to certain surviving
spouses or children of deceased Veterans, or spouses or children of Veterans withpermanent and total service-connected disabilities who are not eligible for TRICARE.

Home Loans
VA can help eligible unmarried surviving spouses (or those remarried after reaching age 57)
become homeowners. This benefit may be used to help you buy, build, refinance, repair,and retain a home for your own personal occupancy. You must be in receipt of Dependency
and Indemnity Compensation (DIC) and the surviving spouse of a Veteran who died: a) on
active or select reserve service, b) from a service-connected cause, or c) was rated totallydisabled for a certain period of time preceding death. Other surviving spouses include: a)spouse of a Service member missing in action or a prisoner of war, and b) spouse of acertain totally disabled Veteran whose disability may not have been the cause of death. For
more information visit the home loan web page2 or call 1-877-827-3702.

Veterans Month of Death Benefits
If a Veteran who is receiving VA compensation or pension benefits passes away, their lastmonth of benefits can be paid to their surviving spouse. This payment is usually automatic,
but if it is not received, it can be claimed via a phone call to 1-800-827-1000, or throughyour Veterans Service Officer (VSO) or County Veterans Service Officer (CVSO).
For additional information regarding eligibility requirements see the Summary of VA
Dependents’ and Survivors’ Benefits3.

VA Life Insurance
As part of our mission to serve Service members, Veterans, and their families, VA provides
valuable life insurance benefits to give you the peace of mind that comes with knowing yourfamily is protected. VA’s life insurance programs were developed to provide financial
security for your family given the extraordinary risks involved in military service.
VA has several different insurance programs. To get the insurance benefits you've earned,
2
3

www.benefits.va.gov/homeloanswww.benefits.va.gov/BENEFITS/benefits-summary/SummaryofVADependentsandSurvivorsBenefits.pdf

5 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

explore your options, manage your policy, update your life insurance beneficiary
designation(s), or file claims, visit www.benefits.va.gov/insurance.
•

Veterans Affairs Life Insurance (VALife): Provides guaranteed acceptance whole life
coverage of up to $40,000 to Veterans with service-connected disabilities. No
medical underwriting is required and there is no time limit to apply for Veterans
aged 80 and under. Veterans aged 81 and over are eligible in some circumstances.
Under this plan, the elected coverage takes effect two years after enrollment as longas premiums are paid during the two-year period. More information available atwww.va.gov/life-insurance/options-eligibility/valife/.

•

Veterans’ Mortgage Life Insurance (VMLI): Offers mortgage protection insurance tothe families of Service members and Veterans with severe service-connecteddisabilities, who have received a specially-adapted housing grant from VA. VMLI
provides decreasing term insurance up to $200,000 or the amount you owe on yourmortgage, whichever is less. More information available at www.va.gov/lifeinsurance/options-eligibility/vmli/.

•

Servicemembers’ Group Life Insurance (SGLI): Provides automatic maximum
coverage up to $500,000 in $50,000 increments. Coverage expires 120 days after
separation from service but can be extended with the SGLI Disability Extension(SGLI-DE) for up to two years following separation if you are totally disabled. You
must apply for the SGLI-DE; it is not automatic. More information available atwww.va.gov/life-insurance/options-eligibility/sgli/.

•

Veterans’ Group Life Insurance (VGLI): allows separating Service members toconvert their SGLI coverage to renewable group term insurance. The initial amountof VGLI available is equal to the amount of SGLI at separation but can be increased in$25,000 increments beginning one year after enrollment, and then every five years
until you are 60 years old. No health questions are required if you apply within 240
days after separation. You have up to 1 year and 120 days after separation to apply
but must meet good health requirements if you apply more than 240 days after
separation. More information available at www.va.gov/life-insurance/optionseligibility/vgli/.

•

Family Servicemembers’ Group Life Insurance (FSGLI): Offers coverage for the
spouse and dependent children of Service members covered under full-time SGLI.
Spouse coverage is up to $100,000 or the amount of the member’s coverage,
whichever is less. Dependent children are covered for $10,000 each at no cost to themember. Spouses who have Family SGLI coverage at the time of the Service
member’s passing have 120 days to apply to convert their coverage to a permanent
plan of insurance with a participating insurer. They can also convert their coverage
upon other key events such as the Service member’s separation from service. Moreinformation available at www.va.gov/life-insurance/options-eligibility/fsgli/.

Under SGLI, FSGLI, and VGLI, terminally ill Service members, spouses of Service members, andVeterans can obtain up to 50% of their insurance coverage prior to death if they have a medical
prognosis of 9 months or less to live.

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Beneficiaries under the SGLI, FSGLI, and VGLI programs are eligible for free financial counselingand online will preparation services for two years from the date of payment of the claim.
Information is provided to beneficiaries at the time of payment.

7 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

What to Do, and When
Preparing for the passing of a loved one, or even oneself, can be a difficult and confusing time. The
following informs you of what you may need to do, and when, to ensure your survivors have theinformation and documents needed to obtain the benefits for which they may be entitled.

For the Veteran, when discussing your final wishes with your loved ones:•

Discuss your military service and any VA disability rating information with your family and if
possible, locate copies of your military separation document(s), such as your DD214.

•

Use VA-Form 21-686C to document your and your spouse’s marital histories. This
information may be needed if your spouse applies for VA benefits after your passing.

•

Discuss your final wishes regarding your remains. If you wish to be buried in a national
cemetery, consider applying now for pre-need burial eligibility.

•

Discuss if any of the life insurance programs VA offers are needed to cover any of your or
your family's expenses.

•

Be sure to complete and annually review your life insurance beneficiary designation(s),which will make it much easier to file a claim and receive benefits quickly.

For the Veteran’s family, as the Veteran is approaching end of life:•

Speak to the Veteran’s doctor about how to obtain copies of medical records before andafter the Veteran’s passing in case they may be needed in the future.

•

Discuss with the Veteran where and when they have received treatment for any medical
conditions which you believe may have been incurred in, or exacerbated by, their military
service.

•If you believe the Veteran may be entering into their period of final illness, begin keeping arecord of any medical expenses related to that final illness.

•

If the Veteran wishes to be interred in a national cemetery, locate their pre-need burial
approval (if they applied), or clarify their wishes as to where they would like to be interred.

For the Veteran’s parents, spouse, or dependent children, after the Veteran’spassing:•

Consider if you wish to apply for VA Survivors Pension or DIC.

•

If the Veteran had a VA Life Insurance policy, or other policy, prepare and submit a claim
required supporting documentation.

•

If you have a medical condition, disease, or injury which necessitates the aid and attendanceof another person in performing your activities of daily life, or are housebound, have yourphysician complete a statement outlining your medical condition.

•

If you believe the Veteran’s death was related to a condition incurred during military
service, or exacerbated by military service, obtain copies of any private medical records
from the Veteran’s physician (VA hospital records and military medical records can beobtained by VA).

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How to Apply for Benefits
When applying for benefits there are basic forms that must be completed. The table below lists
the forms required to apply for various VA benefits, as well as the additional documents that
may be required to show eligibility. This booklet includes copies of the VA forms listed, so you
can familiarize yourself with them now. You can find current versions online atwww.va.gov/vaforms

DESIRED APPLICATION:

FORM REQUIRED:

ADDITIONAL DOCUMENTS THAT
MAY BE REQUIRED:

If you wish to apply for pre-needeligibility in a National Cemetery

VA Form 40-10007

Veteran’s Military Discharge

If you wish to apply for a Burial Flag

VA Form 27-2008

Veteran’s Military Discharge

If you wish to apply for a Government
VA Form 40-1330M
Medallion

Veteran’s Military Discharge

If you wish to apply for a
Headstone/Marker

Veteran’s Military Discharge

VA Form 40-1330

Veteran’s Military Discharge
If you wish to apply for burial benefits VA Form 21P-530EZ

Death Certificate
Transportation Invoice

If you wish to apply for DIC benefits
for the Veteran’s surviving spouse,child/children

VA Form 21P-534EZ

If you wish to apply for DIC benefits
for the Veteran’s surviving
parent/parents

VA Form 21P-535

If you wish to apply for DIC benefits
for the Veteran’s surviving spouse,child/children as a result of combatrelated death

Veteran’s Military Discharge
Death Certificate
Declaration of Status of Dependents(VA Form 21-686c)
Veteran’s Military Discharge
Death Certificate
Declaration of Status of Dependents(VA Form 21-686c)
Veteran’s Military Discharge

VA Form 21P-534a

Death Certificate
Declaration of Status of Dependents(VA Form 21-686c)

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DESIRED APPLICATION:

FORM REQUIRED:

ADDITIONAL DOCUMENTS THAT
MAY BE REQUIRED:
Veteran’s Military Discharge

If you wish to apply for a Survivors
Pension *with aid and attendance orhousebound benefits

Death Certificate
VA Form 21P-534EZ*Examination for HouseboundStatus or Permanent Need for Aidand Assistance (VA Form 21-2680)

If you wish to apply for The Civilian
Health and Medical Program of the
Department of Veterans Affairs(CHAMPVA)

VA Form 10-10d

Veteran’s Military Discharge

VA Form 22-5490

Veteran’s Military Discharge

VA Form 26-1817

Veteran’s Military Discharge

If you wish to apply for the:-Dependents’ Educational
Assistance Program (DEA), or the-

Marine Gunnery Sergeant JohnDavid Fry Scholarship Post-9/11
GI BillIf you wish to apply for a Home Loan

If you wish to apply for any VA Life
Insurance programs*

Military or VA Disability rating
documents
benefits.va.gov/insurance

Military separation documents
Mortgage documents

SGLV 8283/ SGLV 8283A
If you wish to file a claim for VA Life
Insurance that is in effect upon theServicemember’s, Family Member’s,or Veteran Insured’s passing.

SGLV 8284/ SGLV 8284A
SGLV 8721
VA Form 29-4125/
VA Form 29-4125e

Copy of death certificate
Estate or Will documentation*For additional information or to apply for VA Life Insurance policy, visit www.va.gov/lifeinsurance/options-eligibility. All VA Life Insurance Forms can be accessed atwww.benefits.va.gov/INSURANCE/resources-forms.asp. To manage your SGLI beneficiaries as well as
SGLI and Family coverage amounts, visit https://milconnect.dmdc.osd.mil/milconnect/.

10 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

For Help with Your Benefits
Applying for VA benefits, especially at the time of the passing of a loved one, can be difficultand confusing. However, several organizations exist to help you navigate this process, usually
cost-free. Here are a few places you can go for help with the claims process:County Veterans Service Officers
Most local governments in the United States have a designated County Veterans Service
Office or Agency, staffed by County Veterans Service Officers or (“CVSOs”). These officers
operate independent of VA, but receive VA training, and can act as liaisons between
claimants and VA. They are usually well versed in benefits eligibility requirements and claims
processing and are available to help you locally. To find your local CVSO, you can use thedirectory found online at this URL: www.ebenefits.va.gov/ebenefits/vso-search.

Veterans Service Organizations
Veterans Service Organizations (VSO) are private groups dedicated to providing Veteransand their families with various services, including assistance with claims processing. These
groups can help you by representing you before VA and can assist you in completing yourclaim. While these groups are not formally connected to the government or VA, theyreceive VA accreditation and training, and do not charge for their services. To find a VSO,
you can use the directory found online at this URL: www.ebenefits.va.gov/ebenefits/vsosearch.

U.S. National Archives and Records Administration (N A R A)
Veterans and next of kin can obtain free copies of a DD-214 and other service records. Fax
or mail Standard Form SF 1804 (Request Pertaining to Military Records), to the address
indicated on the back of the form, or fill out the form online at this URL:
www.archives.gov/veterans/military-service-records. You may also call NARA customer
service staff at 314-801-0800 if you have questions or require same-day service (e.g.,
upcoming surgery or funeral).

VA Contact Information
If you wish to speak directly to a VA representative, contact VA at the following phone
numbers:

4•

For burial, Survivors Pension, DIC, or other benefits: 1-800-827-1000•

For the status of VA headstones and markers: 1-800-697-6947•

For obtaining bereavement counseling: 1-877-927-8387

https://www.archives.gov/files/research/order/standard-form-180.pdf

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•

For Telecommunications Device for the Deaf services: Dial 711•

For VA Life Insurance information related to Servicemembers’ Group Life Insurance,
Traumatic Servicemembers’ Group Life Insurance, Family Servicemembers’ Group Life
Insurance, and Veterans’ Group Life Insurance: 1-800-419-1473 or visit
www.benefits.va.gov/insurance•

For VA Life Insurance, Veterans' Mortgage Life Insurance or other VA Insurance
programs call: 1-800-669-8477 or visit www.benefits.va.gov/insurance

If you or somebody you know is experiencing a crisis, you can DIAL 9 8 8 for the Veteran’s
Crisis Line and select option 1.

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Record of Personal Affairs
The following is a guide to assist you in consolidating information that will be beneficial for yourloved ones at the time of your passing. This information is for your personal use only and should
NOT be submitted to VA.
Be sure to keep the following guide in a secure location, as it will contain personally identifiable
information.

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MY RECORD OF PERSONAL AFFAIRSFirst Name

Middle Name

Last Name

Retired Military Grade

Branch of Service

Social Security Number

Street Address

City/StateZip Code

Service Number

Date of Entry

Date/Type/Character of
Separation from Military

Date and Place of BirthCity/State/Zip

Month/Day/Year

Parent’s Information
Father’s First Name

Father’s Middle Name

Father’s Last Name

Mother’s First Name

Mother’s Middle Name

Mother’s Last NameChild’s First NameChild’s Middle NameChild’s Last NameChild’s First NameChild’s Middle NameChild’s Last NameChild’s First NameChild’s Middle NameChild’s Last NameChild’s First NameChild’s Middle NameChild’s Last NameChildren’s Information

14 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

Your Marital History
Spouse’s Name

Spouse’s Social Security Number

Spouse’s Birthdate

Location of Marriage (City/State/Country)

Date of Marriage

Spouse’s Prior Name (if applicable)

Date of Prior MarriageYour Total Number of Marriages

Your Spouse’s Total Number of Marriages

Trusted Associates: List a personal lawyer or a trusted friend who may be consulted regarding
your personal or business affairs.
First Name

Middle Name

Last Name

Street Address
Phone Number

City/State/Zip
Email Address

Location of Family Records: In the open space below, to aid your family, list the physicallocation of important documentation and records. Documents may include birth certificates,
adoption paperwork, marriage certificates, naturalization papers, divorce decrees, deathcertificates, tax documents, etc.

15 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

Your Will:
Do you have a will? Circle One: YES

orNO

Location of Will

Executor’s Name and Contact Information

Lawyer’s Name and Contact Information

Power of Attorney: (Personal, not VA assigned)
Do you have a Power of Attorney? Circle One:

YES

or

NO

Name of POA

Location of Document

City/State/Zip

Phone Number

Bank Accounts: In the open space below, list your bank accounts, including the name of thefinancial institution, name of joint account holders, account numbers, and phone numbers.

Credit Cards: In the open space below, list your credit cards, including the name and phone
numbers.

Location of Important Financial Documents: In the open space below, list the location ofimportant financial documents, including savings bonds, stocks, mutual funds, 401K, safe deposit
box, etc.

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Real Estate: If your family needs assistance with your home loan, they can contact VA at phone
number: 1-877-827-3702. You do not need a VA loan to request assistance.
Primary Residence (address)
Mortgage Institution (if applicable)

Location of Physical Mortgage Note

Property Insurance Company

Property Insurance Policy Number

Investment Properties: In the open space below, list any investment properties, including theaddress and location of the deed/note.

Vehicles Owned: List the year, make, model and vehicle ID number (VIN) for each vehicle you
own.

Life Insurance: Place a check mark beside the type/types of life insurance you have (check allthat apply).
Type of Insurance
Department of Veterans Affairs Sponsored Life Insurance
Government Employee (Federal Employee Group Life
Insurance – FEGLI)
Private Employer Sponsored Life Insurance
Private Life Insurance

Insurance Company NameControl/Policy Number

Face Value (Dollars)

17 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

Beneficiary Information:
Name of Beneficiary
Mailing Address

Telephone Number

Payment Option

Other Insurance: In the open space below, list any additional health, vehicle, or other insurance you
have.

Annuities: Government and private.
Payable to (full name)Monthly AmountStreet Address (include City, State, Zip)

Phone Number

Employer Benefits: If employed or retired, list any survivor benefit that may be payable.
Employer

Survivor Benefit

Address (Include City, State, Zip)

Phone Number

Membership in Organizations or Associations: List any organizations with which you areaffiliated that may assist your survivors. Also list other Veteran Service Organizations which may
be of assistance.

Veteran Affairs Record: Survivors should contact the VA at 1-800-827-1000 to report a deathand to discontinue benefits.
VA Claim Number (if applicable)

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Social Security: Survivors should contact their local Social Security Administration office to see
if burial benefits are available.
Social Security Monthly Payment

Location of Social Security Administration Papers

Retirement Pay: Civilian and/or Military
Finance Center

Current Deposit Location

Beneficiary or Any Unpaid Retired Pay

RelationshipPhone Number

Military Documents:
Location of DD-214 (Separation Papers)
Location of Other Military Documents (Awards, Medical, etc.)

Military Survivor/Casualty Assistance Officer: Active and retired military personnel.
Name and Location

Phone Number

Funeral and Burial Arrangements:
Funeral Location

Funeral Director

Address

Phone Number

Church, Clergy or Desired Officiant:
Clergyperson/Officiant Name

Office and/or Home Phone

Name of Institution/Organization

Address of Institution/Organization

For Those Who Wish to be Interred in a VA National Cemetery:
Date of Birth
Date of Entry into Service

Social Security Number

Rank/Branch of Service

Date of Separation

Service Number

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Have you applied for pre-need Eligibility? Visit www.cem.va.gov to learn more.
Other Suggestions and Wishes: List in the space below.

Wishes for Burial and Funeral Service Arrangements:
Name of Resting Place

Phone Number

Hymns, Psalms, Scriptures, Poetry, or Special Requests
Flowers/ Memorial (in lieu of flowers)
Memorial and Remembrances

Do you have a pre-paid burial/plot? Circle One:

Indicate Emblem of Choice for VA Form 40-1330
YES

or

NO

Pallbearers: List pallbearers in the space below.

Special Instructions: List any additional instructions in the space below.

Obituary Biography: Write in the space below.

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Additional Considerations: Please ensure the following are conducted through proper legal
channels:•

Do you have a “do not resuscitate” (D N R) order?

Circle One:

YES

or

NO

•

Do you have a Living Will/ Health Directive?

Circle One:

YES

or

NO

Checklist of Important Documents
The following documents may be needed by survivors. Use the table below to check off the documents you haveand provide their location:

LOCATION OF DOCUMENT

DOCUMENT(write in location)

Military Discharge Documents
Death Certificate (12 copies recommended)
Deceased’s Birth Certificate
Spouse’s Birth Certificate
Minor or Adult Children’s Birth Certificate(s)Marriage Certificate
Other Important Documents

List any other resources and organizations that can assist you:21 | Planning Your Legacy: VA Survivor and Burial Benefits Kit

Completing VA Forms
Applying for any VA benefit requires that you complete an application form, and possibly
additional forms. To ensure speedy and accurate processing of any claim for VA benefits, it
is very important to complete these forms correctly. The following pages contain sample
copies of some VA forms previously mentioned in this document; you can reference thesesamples to see what a properly completed form may look like.

Tips on Completing VA Forms:•

Complete every item on the form, even if your answer is “not applicable”,“none”, or “0”. Incomplete applications are one of the major avoidable causesof denials and delays in processing.

•

The person claiming benefits (the “claimant”; for instance, the surviving spouseclaiming death pension) must sign the form themselves. VA cannot recognize
private power-of-attorney agreements, and family members cannot sign
documents for other family members.

•

VA Forms are periodically updated. Current VA forms can be obtained atwww.va.gov/vaforms or at your local Veterans service office.

•

Visit www.benefits.va.gov/INSURANCE/resources-forms.asp to obtain forms
related to life insurance claims.

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Appendix 1: TABLE OF FREQUENTLY USED FORMSNAME OF FORM DESCRIPTION
VBA-21P-534EZ Application for DIC, Survivors Pension, and/or Accrued Benefits
VBA-22-5490 Dependents’ Application for VA Education Benefits
VA26-1817 Request for Determination of Loan Guaranty Eligibility – Unmarried Surviving
Spouses
VHA-10-10d Application for CHAMPVA Benefits
VBA-21P-530EZ Application for Burial Benefits (Under 38 U.S.C. Chapter 23)
VBA-21P-530A State Application for Internment Allowance (Under 38 U.S.C. Chapter 23)
VA40-1330 Claim for Standard Government Headstone or Marker
VA40-1330M Claim for Government Medallion for Placement in Private Cemetery
VBA-27-2008-ARE Application for United States Flag for Burial Purposes
VA40-10007 Application for Pre-Need Determination of Eligibility for Burial in a VA
National Cemetery
SGLV 8283 Claim for Death Benefits (SGLI/VGLI)SGLV 8284 Servicemember/Veteran Accelerated Benefits Option Form
SGLV 8721 Beneficiary Designation/Change Form
VBA-29-336-ARE Designation of Beneficiary
VBA-29-4125-ARE Claim for One-Sum Payment

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VA PAM 27-18-1
February 2024
P96888