Get Va Headstone Application Fillable Form
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How to fill out the VA Headstone Application Fillable Form online
The VA Headstone Application Fillable Form is essential for requesting a headstone or marker for a deceased veteran. This guide provides clear and step-by-step instructions to help users successfully complete the form online, ensuring all required information is accurately provided.
Follow the steps to fill out the VA Headstone Application Fillable Form online.
- Press the ‘Get Form’ button to access the fillable version of the VA Headstone Application Form through your preferred online document editor.
- Begin by selecting the type of request you are making at the top of the form. Choose from 'Initial Request,' 'Second Request,' or 'Corrected Application or Replacement' based on your situation.
- Input the full name of the deceased individual for whom the headstone or marker will be inscribed. Avoid using nicknames or titles, and provide their first, middle, and last names as required.
- Indicate whether the grave is currently marked with a privately purchased marker or not by checking the appropriate option.
- Complete the veteran’s service and identifying information, including their social security number or service number. Ensure accuracy to avoid processing delays.
- Fill in the dates of birth, death, entry into active military duty, and separation from service, using the specified format (MM/DD/YYYY) without additional characters.
- Provide the highest rank attained by the veteran, ensuring it aligns with the selected branch of service.
- Check the box corresponding to the veteran’s branch of service, ensuring consistency with the rank provided in the previous step.
- Include any valor or award information by checking the applicable boxes and providing documentation as required for any honors listed.
- Select the type of headstone or marker requested by checking one box that best applies.
- Indicate your desired emblem of belief by specifying the emblem number from the list provided.
- Input the contact details of the individual who can provide additional information, including their name, mailing address, daytime phone number, and optional email and fax numbers.
- Complete the certification section by signing and dating the form, confirming that all information is accurate and the headstone will be placed without expense to the government.
- Specify the name and delivery address of the business that will accept the headstone or marker, along with their signature and date.
- Fill out the cemetery details where the grave is located, including name and address, and obtain the required certifications.
- If necessary, use block 27 for any additional remarks regarding the headstone or marker inscription, which may vary in size.
- Once all fields have been completed accurately, save your changes, download a copy of the form, and print or share it as needed for submission.
Start filling out the VA Headstone Application Fillable Form online today to ensure a respectful memorial for your loved one.
VA Form 21-4142a is used to authorize the release of medical records or other information from health care providers. While it does not pertain directly to headstone applications, it’s useful should you need to gather supporting information regarding a veteran's service. For headstone applications, refer specifically to the VA Headstone Application Fillable Form.
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