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  • Va Form 40-1330m 2021

Get Va Form 40-1330m 2021

GENERAL INFORMATION SHEET CLAIM FOR GOVERNMENT MEDALLION FOR PLACEMENT IN A PRIVATE CEMETERY RESPONDENT BURDEN Public reporting burden for this collection of information is estimated to average 15.

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How to fill out the VA Form 40-1330M online

Filling out the VA Form 40-1330M online is an essential step in claiming a government medallion for placement in a private cemetery. This comprehensive guide aims to provide clear instructions tailored to meet the needs of all users, facilitating the completion of the form accurately and effectively.

Follow the steps to complete your VA Form 40-1330M online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. In section 1, indicate whether the VA previously determined eligibility for burial at a VA national cemetery by selecting 'Yes,' 'No,' or 'Unsure.'
  3. Complete section 2 with the name of the deceased veteran, including their first, middle (or initial), last, and suffix.
  4. In section 3, confirm the status of the grave marking by selecting 'Yes' or 'No.' Ensure there is a set headstone, mausoleum, or crypt in place.
  5. Fill out the veteran's personal information in sections 4 through 11, providing details on race or ethnicity, sex, age at death, social security number or service number, place of birth, date of birth, date of death, dates of military service, and branch of service.
  6. In section 12, choose the size of the requested medallion—large, medium, or small—by checking the appropriate box.
  7. Indicate in section 13 your relationship to the deceased veteran, your role, or if you are a veteran service officer, cemetery management, or personal representative.
  8. Complete the claimant's contact information in sections 14 through 16, including name, mailing address, daytime phone number, and email address if applicable.
  9. In section 17, specify if you wish to request a Presidential Memorial Certificate by selecting 'Yes' or 'No.' If yes, indicate how many in section 18.
  10. Certify the accuracy of the information by signing the form in section 19 and entering the date in section 20.
  11. Provide the name and delivery address for the medallion in section 21 and fill out the daytime phone number in section 22.
  12. Enter the cemetery's name and address where the privately purchased headstone is located in section 23.
  13. Ensure the cemetery official signs and dates the form in sections 24 and 25.
  14. Upon completing the form, save your changes, and consider downloading, printing, or sharing to submit your claim.

Complete your VA Form 40-1330M online today to secure your claim for the government medallion!

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For a Government-furnished medallion to be affixed to a headstone or marker in private cemetery, a VA Form 40-1330M, Claim for Government Medallion for Placement in a Private Cemetery must be submitted by a member of the decedent's family.

FAX VA Form 40-1330 and supporting documents to: 1-800-455-7143. This fax line is dedicated to the transmission of applications for the headstone, marker, or medallion.

MAIL claims to: NCA FP Evidence Intake Center PO Box 5237 Janesville, WI 53547 FAX VA Form 40-1330M claims and supporting documents to 1-800-455-7143.

The VA Form 40-1330 is the US Department of Veterans Affairs form otherwise called the Claim for Standard Government Headstone or Marker. This form can be completed in regard to any deceased veteran discharged under honorable conditions and any member of the US Army who dies on active duty.

Equal to VA Form 21P-530 (Application for Burial Benefits).

Use VA Form 40-10007 to find out in advance if you can be buried in a VA national cemetery or when you're applying on behalf of a Veteran or service member.

The VA Form 40-1330 is the US Department of Veterans Affairs form otherwise called the Claim for Standard Government Headstone or Marker. This form can be completed in regard to any deceased veteran discharged under honorable conditions and any member of the US Army who dies on active duty.

For a headstone, grave marker, or niche marker, fill out the Claim for Standard Government Headstone or Marker (VA Form 40-1330).

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VA Form 40-1330M
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2022 VA Form 40-1330M
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  • 2022 VA Form 40-1330M
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