VAU.S. Departmentof Veterans Affairs

The Department of Veterans Affairs (VA) offers this survivors and burial benefits kit as a sourceof pre-need planning information and record storage for Veterans and their families. This kitis intended to be used as a supplement to the Summary of VA Dependents’ and Survivors’Benefits pamphlet.Included you will find Planning for the Future, a section to guide you through possible end-of-lifeand survivors’ benefits eligibility. This section will tell you what benefits are offered and whenand how you should apply.For your added benefit, we have provided space for you to add your own personal informationthat can be kept in one location for your use, and for the use of loved ones. These sectionsidentify the location of important documents, account numbers, military discharge documents,and marital information.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 is our sincere desire that the information and documents contained in this brochure assistyou 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.Planning Your Legacy: VA Survivors and Burial Benefits Kit1

Planning for the FutureVA 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 survivorsknow what benefits are available to them.The following benefits are available to Veterans and their families:Pre-Need Eligibility for National Cemetery Burial or MemorializationVA provides for a fnal resting place for eligible Veterans, spouses, and their eligibledependents, as well as a headstone or marker, a fag to drape the casket and a PresidentialMemorial Certifcate.Memorial or Burial FlagsA United States fag is provided, at no cost, to drape the casket or accompany the urn of adeceased Veteran who served honorably in the U. S. Armed Forces. U.S. Post Ofces are theprimary issuing point for burial fags. Each family of a decedent is entitled to one fag.Government Headstones or MarkersVA can provide a single headstone, columbarium niche cover, or a fat marker for a Veteran’sfnal resting place (private, state or national cemeteries).Cemetery MedallionsVA 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 CertificatesVA can provide a Presidential Memorial Certifcate (PMC) to the family of the deceasedVeteran. A PMC is an engraved paper certifcate signed by the current President.Burial Benefits and Burial Automatic PaymentsBurial benefts are paid to a spouse, designated family member, or executor to partiallyofset the cost of burial expenses, plot costs, and transportation costs for a Veteran’s remains.These benefts are paid at diferent rates based on whether the Veteran’s death was serviceconnected or non-service connected.If the Veteran was receiving VA benefts prior to their passing and had a spouse of record,these benefts will usually be paid automatically to that spouse. However, additional funds maybe paid, or payment made to another party, if an application is completed. Additional benefts,including a plot or interment allowance and transportation allowance, may also be payable.2 Planning Your Legacy: VA Survivors and Burial Benefts Kit

An application for non-service-connected burial benefts must be submitted within two yearsfrom the date of death. There is no time limit for a service-connected death.Dependency and Indemnity CompensationDependency and Indemnity Compensation (DIC) is a monthly tax-free beneft provided to aneligible surviving spouse, dependent child(ren), and/or parent(s) of a deceased Servicememberor Veteran.DIC benefts paid to surviving spouses and children are not income based. Parents DIC is anincome-based beneft for parents who were fnancially dependent on of a Servicemember orVeteran who died from a service-related cause.Dependents’ Educational Assistance ProgramThe Dependents’ Educational Assistance Program ofers education and training opportunitiesto eligible dependents of Veterans who are permanently and totally disabled due to a servicerelated condition or of Serviciemembers who died during active military service or Veterans whodied as a result of a service-related condition.Marine Gunnery Sergeant John David Fry ScholarshipProvides children with fnancial support for tuition and fees, books and supplies, and housing.You may be eligible for up to 36 months of Fry Scholarship benefts if you are the child of aServicemember who died during active duty after September 10, 2001. You must use yourbenefts between your 18th and 33rd birthdays. You may still be eligible if you are married.The 15-year time limitation for using Post-9/11 GI Bill benefts is eliminated for qualifyingdependents (Fry children who became eligible on or after January 1, 2013 and all Fry spouses).Survivors PensionA net worth and income-based beneft paid to un-remarried surviving spouses and childrenof a wartime Veteran whose death is not service related. Survivors Pension pays a maximumannual amount, which is ofset by the benefciary’s income from other sources. Certaindeductible expenses, such an unreimbursed medical expenses, may be used to reduce thesurvivor’s countable income.Special Monthly Pension BenefitsThis is additional funds available to survivors in receipt of pension who are, due to a mentalor physical disability, blind, require the aid and attendance of another person in performingdaily activities, or are permanently housebound. Qualifying for this beneft requires medicalevidence from a doctor or specialist.Planning Your Legacy: VA Survivors and Burial Benefits Kit3

The Civilian Health and Medical Program of theDepartment of Veterans AffairsA beneft that provides reimbursement for most medical expenses to certain surviving spousesand dependents of Veterans with permanent and total service-connected disabilities who are noteligible for TRICARE.Home LoansVA helps eligible surviving spouses become homeowners. This beneft may be used to help youbuy, build, repair, retain, or adapt a home for your own personal occupancy.Veterans Month of Death BenefitsIf a Veteran who is receiving VA compensation or pension benefts passes away, their lastmonth of benefts 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 yourCounty Veterans Service Ofcer (CVSO).For additional information regarding eligibility requirements see the Summary of VADependents’ and Survivors’ Benefts.4 Planning Your Legacy: VA Survivors and Burial Benefts 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 havethe information 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 with your family and if possible, locate copies of yourmilitary separation document(s), such as your DD214. Document your spouse’s and your marital histories. This information may be neededif your spouse applies for VA benefits after your passing. Discuss your final wishes regarding your remains. If you wish to be buried in a nationalcemetery after your passing, consider applying now for pre-need burial eligibility.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 medicalconditions which you believe may have been incurred in, or exacerbated by, their militaryservice. If you believe the Veteran may be entering into their period of final illness, begin keepinga 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 burialapproval (if they applied), or clarify their wishes as to where they would like be interred.For the Veteran’s parents, spouse, or dependent children,after the Veteran’s passing: Consider if you wish to apply for VA Survivors Pension or DIC. If you have a medical condition, disease, or injury which necessitates the aid andattendance of another person in performing your activities of daily life, or arehousebound, have your physician complete a statement outlining your medical condition. If you believe the Veteran’s death was related to a condition incurred during militaryservice, or exacerbated by military service, obtain copies of any private medical recordsfrom the Veteran’s physician (VA hospital records and military medical records can beobtained by VA).Planning Your Legacy: VA Survivors and Burial Benefits Kit5

How to Apply for Benefits When applying for benefits there are basic forms that must be completed. This page lists theforms required to apply for various VA benefits, as well as what additional documents maybe required to show eligibility. This booklet includes copies of the VA forms listed, so you canfamiliarize yourself with them now. You can find current versions online at FORM:ADDITIONAL DOCUMENTS THATMAY BE REQUIRED you wish to apply for pre-needeligibility in a National CemeteryVA Form 40-10007 Veteran’s Military Discharge you wish to apply for a:-Burial Flag-Government Medallion, or-Headstone/Marker you wish to apply forburial benefits you wish to apply for DICbenefits for the Veteran’s:-surviving spouse/child(ren)-surviving parent(s)-surviving spouse/child(ren)as a result of combat-related death you wish to apply for a:Survivors Pension (*with aid andattendance or houseboundbenefits) Veteran’s Military DischargeVA Form 27-2008VA Form 40-1330MVA Form 40-1330VA Form 21P-530 Veteran’s Military Discharge Death Certificate Transportation Invoice Veteran’s Military DischargeVA Form 21-534EZVA Form 21P-535VA Form 21P-534aVA Form 21P-534EZ6 Planning Your Legacy: VA Survivors and Burial Benefts Kit Death Certificate Declaration of Status ofDependents (VA Form 21-686c) Veteran’s Military Discharge Death Certificate *Examination for HouseboundStatus or Permanent Need forAid and Attendance(VA Form 21-2680)

IF:USE FORM:ADDITIONAL DOCUMENTS THATMAY BE REQUIRED you wish to apply for The CivilianVA Form 10-10dHealth and Medical Program of theDepartment of Veterans Affairs (CHAMPVA) Veteran’s Military Discharge you wish to apply for a:-Dependents’ EducationalAssistance Program (DEA)-Marine Gunnery SergeantJohn David Fry Scholarship Post9/11 GI BillVA Form 22-5490 Veteran’s Military Discharge you wish to apply forhome loanVA Form 26-1817 Veteran’s Military DischargePlanning Your Legacy: VA Survivors and Burial Benefits Kit7

For Help With Your Benefits Applying for VA benefits, especially at the time of passing of a loved one, can be difficultand confusing. However, several organizations exist to help you navigate this process, usuallycost-free.Here are a few places you can go for help with the claims process:CVSOsMost local governments in the United States have a designated County Veterans Service Ofceor Agency, stafed by County Veterans Service Ofcers (or “CVSOs”). These ofcers operateindependent of VA, but receive VA training, and can act as liaisons between claimants and VA.They are usually well versed in benefts eligibility requirements and claim processing, and areavailable to help you locally. To fnd your local CVSO, you can use the directory found online at thisURL: terans Service OrganizationsVeterans Service Organizations (VSO) are private groups dedicated to providing Veterans andtheir families with a number of services, including assistance with claims processing. Thesegroups can help you by representing you before VA, and can assist you in completing yourclaim. While these groups are not formally connected to government or VA, they receive VAaccreditation and training, and do not charge for their services. To fnd a VSO, you can use thedirectory found online at this URL: Contact InformationIf you wish to speak directly to a VA representative, contact VA at the followingphone numbers: For burial, Survivors Pension, DIC, or other benefits: 1-877-294-6380. For the status of VA headstones and markers: 1-800-697-6947. For obtaining bereavement counseling: 1-202-461-6530. For Telecommunications Device for the Deaf services, dial 711.If you or somebody you know is experiencing a crisis, you can contact VA’sVeterans Crisis Line at 1-800-273-TALK (1-800-273-8255).8 Planning Your Legacy: VA Survivors and Burial Benefts Kit

Record of Personal AffairsThe 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 shouldnot be submitted to VA.Be sure to keep the following information in a secure location, as it will contain personallyidentifiable information.Planning Your Legacy: VA Survivors and Burial Benefits Kit9

My Record of Personal Affairs:FirstMiddleLastRe red Military GradeBranch of ServiceSSNStreet AddressCity/StateZip CodeService NumberDate of Entry and Date, Type, and Character of separa on from militaryDate and Place of Birth:City, State, ZipMonth/Day/YearParents’ OBSSNFirstMiddleLastDOBSSNFirstMiddleLast10 Planning Your Legacy: VA Survivors and Burial Benefts KitDOBSSN

Your Marital History:Your spouse’s nameSpouse’s SSNSpouse’s birthdateLocation of marriage (city, state/country)Date of marriageYour prior spouse’s name (if applicable)Date of prior marriageLocation of prior marriage (city, state/country)Date/place/circumstance of end of marriage (if applicable)Your total number of marriagesYour spouse’s total number of marriagesTrusted Associates: List a personal lawyer or trusted friend who may be consulted in regard to per‐sonal or business affairs.FirstMiddleLastAddressPhoneEmailLocation of Family Records: List the physical location(s) where your family can find importantdocumentation. Documents can include; birth certificates, adoption paperwork, marriage certificate, natu‐ralization papers, divorce decrees, death certificates, tax documents, etc.Planning Your Legacy: VA Survivors and Burial Benefits Kit11

Your Will:Do you have a will ? Circle one:YesNoLocation of WillExecutor’s name & contact informationLawyer’s name and contact informationPower of Attorney: Personal, not VA assigned. Do you have a POA? Circle one:YesNoName of POALocation of documentCity, state zipPhoneBank Accounts: Include name of financial institution, name of joint account holders, account number,and phone number.Credit Cards: Include name and phone number.Location of Important Financial Documents: Include savings bonds, stocks, mutualfunds, 401K, safe deposit box, etc.12 Planning Your Legacy: VA Survivors and Burial Benefts Kit

Real Estate: If your family needs any assistance with your home loan, they can contact a VA RegionalLoan Center at 1‐877‐827‐3702 for assistance. You do not need a VA Loan to request assistance.Primary Residence (address)Mortgage Institution (If applicable)Location of physical Mortgage noteProperty insurance (include company and policy number)Investment Properties: Include address(es) and location of deed/note.Vehicles owned: List the year, make, model and vehicle ID number (VIN) for each vehicle you own.Life Insurance:Circle the following types of insurance you have:GovernmentLifeMortgageList the insurance company, policy number, face value and payment option below.Other Insurance: List any health, vehicle, or other insurance you have.Planning Your Legacy: VA Survivors and Burial Benefits Kit13

Annuities: Government and private.Payable to (full name)Monthly AmountAddress (city, state, zip)PhoneEmployer / Membership: If employed (or retired), list any survivor bene t that may be payable.EmployerSurvivor Bene tCity, state, zipPhoneMembership in Organizations or Associations: List any organizations with which youare affiliated that may assist your survivors. Also list other local Veteran Service Organizations which may beof assistance.Veterans Affairs Record: Survivors should contact VA at 1‐800‐827‐1000 to report death and dis‐continue benefits .VA claim number (if applicable)Social Security: Survivors should contact local SSA office to see if burial bene ts are available.Social Security monthly paymentLocation of SSA papersRetirement Pay: Civilian and/or militaryCurrent deposit locationFinance centerBene ciary or any unpaid retired payRelationship14 Planning Your Legacy: VA Survivors and Burial Benefts KitPhone

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.PhoneName and LocationFuneral and Burial Arrangements:Funeral directorFuneral LocationAddressPhoneChurch, Clergy or Desired Officiant:Clergyperson/OfficiantOffice PhoneHome PhoneAddressName of institution/organizationFor Those Who Wish to be interred in a VA National Cemetery:Date of birthSocial Security NumberRank / Branch of serviceDate of entry into serviceDate of separationService numberOther Suggestions or Wishes:Planning Your Legacy: VA Survivors and Burial Benefits Kit15

Wishes for Burial and Funeral Service Arrangements:Name of resting placePhoneHymns, psalms, scriptures, poetry, or special requestsFlowers / memorial (if in lieu of owers)Memorial and remembrancesIndicate emblem choice for VA Form 40-1330Do you have a pre-paid burial/plot? Circle one:YesNoPallbearers:Special instructions:Obituary Biography:16 Planning Your Legacy: VA Survivors and Burial Benefts Kit

Additional ConsiderationsPlease ensure the following are conducted though proper legal channels. Do you have a “do not resuscitate” (DNR) order? Yes No Do you have a living will / health directive? Yes NoChecklist of Important DocumentsThe following may be needed by survivors:Death Certificate (12 copies recommended) Location:Deceased’sBirthSpouse’s BirthCertificateLocation:Certificate Location:Minor or Adult Dependent Children’s Birth Certificate(s) Location:MarriageCertificateLocation:Other Important Documents Location:Other resources and organizations that can assist you:Planning Your Legacy: VA Survivors and Burial Benefits Kit17

Completing VA FormsApplying for any VA benefit requires that you complete an application form, and possiblyadditional forms. To ensure speedy and accurate processing of any claim for VA benefits, it isvery important to complete these forms correctly. The following are sample copies of some VAforms previously mentioned in this document; you can reference these samples to see what aproperly completed claim 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 causes of denials and delaysin processing.The person claiming benefits (the “claimant”; for instance the surviving spouse claimingdeath pension) must sign the form themselves. VA cannot recognize private power-ofattorney agreements, and family members cannot sign documents for other familymembers.VA Forms are periodically updated; the forms you