Planning Your Legacy: VA Survivors and Burial Benefits Kit

Planning Your Legacy

VA Survivors and Burial Benefits

Our Mission: To fulll President Lincoln’s promise to care

for those who have served in our naon’s military and for

their families, caregivers, and survivors.

2 | Planning Your Legacy: VA Survivor and Burial Benets Kit

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 is

intended to be used as a supplement to the Summary of VA Dependents’ and Survivors’ Benefits

pamphlet

Included you will find a section entitled Planning for the Future to guide you through end-of-life

and survivors’ benefits eligibility. This section will tell you what benefits are offered and when

and how you should apply.

For your convenience, we have provided space for you to add your own personal information

that 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, account

numbers, military discharge documents, and marital information.

Additionally, we have provided samples of completed forms that may be needed in the

application process. VA forms change periodically; current versions can be found online at

www.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.

hps://benets.va.gov/BENEFITS/benets-summary/SummaryofVADependentsandSurvivorsBenets.pdf

3 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Planning for the Future

VA has benefits designed to aid you and your family in preparing for the future. The documents

in 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 Naonal Cemetery Burial or Memorializaon

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 for

each 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 cemetery

to signify a decedent’s status as Veteran. Multiple sizes are available.

Presidenal Memorial Cercates

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 Benets and Burial Automac 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, these

benefits 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 a

plot 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.

4 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Dependency and Indemnity Compensaon

Dependency and Indemnity Compensation (DIC) is a monthly tax-free benefit provided to an

eligible 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 to

survivors 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’ Educaonal Assistance Program

The Dependents’ Educational Assistance Program offers education and training

opportunities to eligible dependents, including dependents of Veterans who are

permanently 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 a

result 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 33rd

birthdays, and you may still be eligible if you are married. If you are the surviving spouse

and 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 not

service-related. Certain deductible expenses, such as an unreimbursed medical expense,

may be used to reduce the survivor’s countable income.

5 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Special Monthly Pension Benets

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 another

person, or are housebound, may be eligible for additional monetary payment. These

benefits 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 Aairs

A program that provides reimbursement for some medical expenses to certain surviving

spouses or children of deceased Veterans, or spouses or children of Veterans with

permanent 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 totally

disabled 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 a

certain totally disabled Veteran whose disability may not have been the cause of death. For

more information visit the home loan web page

or call 1-877-827-3702.

Veterans Month of Death Benets

If a Veteran who is receiving VA compensation or pension benefits passes away, their last

month 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 through

your Veterans Service Officer (VSO) or County Veterans Service Officer (CVSO).

For additional information regarding eligibility requirements see the Summary of VA

Dependents’ and Survivors’ Benefits

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 your

family 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,

www.benets.va.gov/homeloans

www.benets.va.gov/BENEFITS/benets-summary/SummaryofVADependentsandSurvivorsBenets.pdf

6 | Planning Your Legacy: VA Survivor and Burial Benets 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 long

as premiums are paid during the two-year period. More information available at

www.va.gov/life-insurance/options-eligibility/valife/.

• Veterans’ Mortgage Life Insurance (VMLI): Offers mortgage protection insurance to

the families of Service members and Veterans with severe service-connected

disabilities, 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 your

mortgage, whichever is less. More information available at www.va.gov/life-

insurance/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 at

www.va.gov/life-insurance/options-eligibility/sgli/.

• Veterans’ Group Life Insurance (VGLI): allows separating Service members to

convert their SGLI coverage to renewable group term insurance. The initial amount

of 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/options-

eligibility/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 the

member. 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. More

information available at www.va.gov/life-insurance/options-eligibility/fsgli/.

Under SGLI, FSGLI, and VGLI, terminally ill Service members, spouses of Service members, and

Veterans 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.

7 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Beneciaries under the SGLI, FSGLI, and VGLI programs are eligible for free nancial counseling

and online will preparaon services for two years from the date of payment of the claim.

Informaon is provided to beneciaries at the me of payment.

8 | Planning Your Legacy: VA Survivor and Burial Benets Kit

What to Do, and When

Preparing for the passing of a loved one, or even oneself, can be a dicult and confusing me. The

following informs you of what you may need to do, and when, to ensure your survivors have the

informaon and documents needed to obtain the benets for which they may be entled.

For the Veteran, when discussing your nal 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 and

after 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 a

record 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, aer the Veteran’s

passing:

• 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 attendance

of another person in performing your activities of daily life, or are housebound, have your

physician 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 be

obtained by VA).

9 | Planning Your Legacy: VA Survivor and Burial Benets Kit

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 at

www.va.gov/vaforms

DESIRED APPLICATION:

FORM REQUIRED:

ADDITIONAL DOCUMENTS THAT

MAY BE REQUIRED:

If you wish to apply for pre-need

eligibility 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

Medallion

VA Form 40-1330M

Veteran’s Military Discharge

If you wish to apply for a

Headstone/Marker

VA Form 40-1330

Veteran’s Military Discharge

If you wish to apply for burial benefits

VA Form 21P-530EZ

Veteran’s Military Discharge

Death Certificate

Transportation Invoice

If you wish to apply for DIC benefits

for the Veteran’s surviving spouse,

child/children

VA Form 21P-534EZ

Veteran’s Military Discharge

Death Certificate

Declaration of Status of Dependents

(VA Form 21-686c)

If you wish to apply for DIC benefits

for the Veteran’s surviving

parent/parents

VA Form 21P-535

Veteran’s Military Discharge

Death Certificate

Declaration of Status of Dependents

(VA Form 21-686c)

If you wish to apply for DIC benefits

for the Veteran’s surviving spouse,

child/children as a result of combat-

related death

VA Form 21P-534a

Veteran’s Military Discharge

Death Certificate

Declaration of Status of Dependents

(VA Form 21-686c)

10 | Planning Your Legacy: VA Survivor and Burial Benets Kit

DESIRED APPLICATION:

FORM REQUIRED:

ADDITIONAL DOCUMENTS THAT

MAY BE REQUIRED:

If you wish to apply for a Survivors

Pension *with aid and attendance or

housebound benefits

VA Form 21P-534EZ

Veteran’s Military Discharge

Death Certificate

*Examination for Housebound

Status or Permanent Need for Aid

and 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

If you wish to apply for the:

- Dependents’ Educational

Assistance Program (DEA), or the

- Marine Gunnery Sergeant John

David Fry Scholarship Post-9/11

GI Bill

VA Form 22-5490

Veteran’s Military Discharge

If you wish to apply for a Home Loan

VA Form 26-1817

Veteran’s Military Discharge

If you wish to apply for any VA Life

Insurance programs*

benefits.va.gov/insurance

Military or VA Disability rating

documents

Military separation documents

Mortgage documents

If you wish to file a claim for VA Life

Insurance that is in effect upon the

Servicemember’s, Family Member’s,

or Veteran Insured’s passing.

SGLV 8283/ SGLV 8283A

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/life-

insurance/options-eligibility. All VA Life Insurance Forms can be accessed at

www.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/.

11 | Planning Your Legacy: VA Survivor and Burial Benets Kit

For Help with Your Benefits

Applying for VA benefits, especially at the time of the passing of a loved one, can be difficult

and 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 Ocers

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 the

directory found online at this URL: www.ebenefits.va.gov/ebenefits/vso-search.

Veterans Service Organizaons

Veterans Service Organizations (VSO) are private groups dedicated to providing Veterans

and 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 your

claim. While these groups are not formally connected to the government or VA, they

receive 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/vso-

search.

U.S. Naonal Archives and Records Administraon (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 180

(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 Informaon

If you wish to speak directly to a VA representative, contact VA at the following phone

numbers:

• 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

hps://www.archives.gov/les/research/order/standard-form-180.pdf

12 | Planning Your Legacy: VA Survivor and Burial Benets Kit

• 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.

13 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Record of Personal Affairs

The following is a guide to assist you in consolidating information that will be beneficial for your

loved 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.

14 | Planning Your Legacy: VA Survivor and Burial Benets Kit

MY RECORD OF PERSONAL AFFAIRS

First Name

Middle Name

Last Name

Retired Military Grade

Branch of Service

Social Security Number

Street Address

City/State

Zip Code

Service Number

Date of Entry

Date/Type/Character of

Separation from Military

Date and Place of Birth

City/State/Zip

Month/Day/Year

Parent’s Informaon

Father’s First Name

Father’s Middle Name

Father’s Last Name

Mother’s First Name

Mother’s Middle Name

Mother’s Last Name

Children’s Informaon

Child’s First Name

Child’s Middle Name

Child’s Last Name

Child’s First Name

Child’s Middle Name

Child’s Last Name

Child’s First Name

Child’s Middle Name

Child’s Last Name

Child’s First Name

Child’s Middle Name

Child’s Last Name

15 | Planning Your Legacy: VA Survivor and Burial Benets 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 Marriage

Your 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 aairs.

First Name

Middle Name

Last Name

Street Address

City/State/Zip

Phone Number

Email Address

Locaon of Family Records: In the open space below, to aid your family, list the physical

locaon of important documentaon and records. Documents may include birth cercates,

adopon paperwork, marriage cercates, naturalizaon papers, divorce decrees, death

cercates, tax documents, etc.

16 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Your Will:

Do you have a will? Circle One: YES or NO

Location of

Will

Executor’s Name and Contact Information

Lawyer’s Name and Contact Information

Power of Aorney: (Personal, not VA assigned)

Do you have a Power of Aorney? 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 the

nancial instuon, 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.

Locaon of Important Financial Documents: In the open space below, list the locaon of

important nancial documents, including savings bonds, stocks, mutual funds, 401K, safe deposit

box, etc.

17 | Planning Your Legacy: VA Survivor and Burial Benets Kit

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 Properes: In the open space below, list any investment properes, including the

address and locaon 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 all

that 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 Name

Control/Policy Number

Face Value (Dollars)

18 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Beneciary Informaon:

Name of Beneficiary

Mailing Address

Telephone Number

Payment Option

Other Insurance: In the open space below, list any addional health, vehicle, or other insurance you

have.

Annuies: Government and private.

Payable to (full name)

Monthly Amount

Street Address (include City, State, Zip)

Phone Number

Employer Benets: If employed or rered, list any survivor benet that may be payable.

Employer

Survivor Benefit

Address (Include City, State, Zip)

Phone Number

Membership in Organizaons or Associaons: List any organizaons with which you are

aliated that may assist your survivors. Also list other Veteran Service Organizaons which may

be of assistance.

Veteran Aairs Record: Survivors should contact the VA at 1-800-827-1000 to report a death

and to disconnue benets.

VA Claim Number (if applicable)

19 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Social Security: Survivors should contact their local Social Security Administraon oce to see

if burial benets are available.

Social Security Monthly Payment

Location of Social Security Administration Papers

Rerement Pay: Civilian and/or Military

Finance Center

Current Deposit Location

Beneficiary or Any Unpaid Retired Pay

Relationship

Phone Number

Military Documents:

Location of DD-214 (Separation Papers)

Location of Other Military Documents (Awards, Medical, etc.)

Military Survivor/Casualty Assistance Ocer: Acve and rered military personnel.

Name and Location

Phone Number

Funeral and Burial Arrangements:

Funeral Location

Funeral Director

Address

Phone Number

Church, Clergy or Desired Ociant:

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 Naonal Cemetery:

Date of Birth

Social Security Number

Rank/Branch of Service

Date of Entry into Service

Date of Separation

Service Number

20 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Have you applied for pre-need Eligibility? Visit www.cem.va.gov to learn more.

Other Suggesons 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

Indicate Emblem of Choice for VA Form 40-1330

Do you have a pre-paid burial/plot? Circle One: YES or NO

Pallbearers: List pallbearers in the space below.

Special Instrucons: List any addional instrucons in the space below.

Obituary Biography: Write in the space below.

21 | Planning Your Legacy: VA Survivor and Burial Benets Kit

Addional Consideraons: 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 have

and provide their location:

DOCUMENT

LOCATION OF 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