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VA Form 40-1330M Printable, Fillable in PDF – Request for Government Medallion for Interment in a Private Cemetery (VA Form 40-1330M) is a form that is used to request that the government supply a medallion for the dead veteran’s interment in a private cemetery. This form should be completed by the authorized person or a member of the deceased’s immediate family member. This form should be filled in the case of a dead veteran who was released under honorable terms, as well as any member of the United States Army who dies while on active service in the United States.
According to the United States Department of Veterans Affairs (VA), the most recent version of the form was issued on December 1, 2017, and the existing stock of earlier versions was utilized. A fillable VA Form 40-1330M is available for download below, or it may be accessed on the VA’s website by searching for “VA Form 40-1330M.”
A similar form, VA Form 40-1330, Claim for Standard Government Headstone or Marker, is used to request a headstone or a marker from the Department of Veterans Affairs. All soldiers are entitled to a regular headstone, marker, or medallion, depending on their preference.
The VA Form 40-1330M Is A Complicated Document To Fill Out
The following are the instructions for VA Form 40-1330M:
- Fill out the form with your personal information. Include your complete name, phone number, fax number, and the total number of pages in your submission.
- Fill in Box 1 if the Veterans Administration has already verified your eligibility for burial in a VA State Cemetery. In Box 2, type the name of the dead person who will be commemorated on the medallion. In Box 3, please indicate whether or not the veteran’s grave is marked. Fill out Boxes 4 and 5 with information on the deceased’s ethnicity and gender. In Box 6, provide the age of the deceased at the time of death.
- The veteran’s social security number and service number should be included in Box 7, as well as their place of birth in Box 8. Fill in the blanks with their dates of birth and death. Please fill out Box 10 with information regarding the veteran’s periods of active duty military service. In Box 11, indicate the branch of service they are affiliated with.
- In Box 12, please specify the size of the medallion you want. Fill in the blanks with your connection to the deceased in Box 13. Enter your name, phone number, and email address in boxes 14 through 16 of the form. Specify whether or not a presidential memorial certificate is necessary for Box 17, and the total number of certificates required in Box 18.
- Fill out Box 19 with your signature, and Box 20 with your date of birth. Box 21 asks for the name of the person who will receive the medallion as well as the address where it will be delivered. Box 22 should be filled out with this person’s phone number. In Box 23, please provide the name and location of the cemetery where the medallion will be installed. Box 24 contains the signature of the cemetery authority from the location of the burial, and Box 25 has the date on which the form was signed.