Form VA40-10088 Request for Casket/Urn Allowance

OMB Approved No. 2900-0799
Respondent Burden: 10 Minutes
Expiration Date: 07/31/2026

REQUEST FOR CASKET/URN ALLOWANCE

(For a deceased Veteran buried in a VA National, State, or Tribal Cemetery with no next-of-kin and insufficient resources for burial)
RESPONDENT BURDEN: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this project is 2900-0799, and it expires 07/31/2026. Statutory authority for casket or urn allowance
is 38 U.S.C. 2306 for deaths occurring on or after January 10, 2014 if interred in a VA national cemetery or on or after December 14, 2016 if interred in a VA-funded
State or Tribal cemetery. Public reporting burden for this collection of information is estimated to average 10 minutes per respondent, per year, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate and any other aspect of this collection of information, including suggestions for reducing the burden, to VA Reports Clearance
Officer at VACOPaperworkReduAct@va.gov. Please refer to OMB Control No. 2900-0799 in any correspondence. Do not send your completed VA Form 40-10088 to
this email address.
PRIVACY ACT INFORMATION: VA is asking you to provide the information on this form under 38 U.S.C. Section 2306 in order for VA to obtain information
sufficient to provide allowance for the purchase of a casket or an urn, if that Veteran has no next-of-kin that is willing or able to pay for the burial and insufficient
resources for burial. VA may disclose the information that you put on the form as permitted by law. VA may make a "routine use" disclosure of the information as
outlined in the applicable Privacy Act system of records notice (48VA40B, Veterans (Deceased) Headstone or Marker Records - VA, as published in the Federal
Register on August 26, 1975, (40 FR 38095)). Providing the requested information is voluntary, but if any or all of the requested information is not provided, it may
delay or result in denial of your request for allowance. VA may also use this information to identify Veterans and persons claiming or receiving VA benefits and their
records and for other purposes authorized or required by law.

PART I - APPLICATION AND CERTIFICATION (Completed by the Applicant)
INSTRUCTIONS FOR SUBMITTING A REQUEST FOR ALLOWANCE: Type or print clearly all information required. This part serves as a means for
applicants to certify information that is necessary to claim allowance for a casket or urn purchased for unclaimed deceased Veterans with insufficient resources for
burial. To apply for allowance, applications should be submitted to the National Cemetery Administration Finance Service via fax 314-416-6340 or via mail to
Department of Veterans Affairs, Attention: NCA Finance Services, P.O. Box 141, Triangle, VA 22172.
Applicants must also have a Vendor ID on file with the VA Finance Service Center (FCS). Applicants who do not have a Vendor ID may submit, either before or after
the interment, a completed and signed FSC Vendor File Request Form (VA Form 10091) to the NCA Finance Service at the above address (Attention: Casket and
Urn Program). Applicants may download the form at http://vaww.va.gov/vaforms/va/pdf/VA10091.pdf.
PLEASE NOTE: VA will not process the allowance request unless the applicant has completed all requirements in Parts I of this form and submitted all required
documentation for allowance.
1. NAME OF DECEASED VETERAN

3. SERVICE NUMBER (if

2. SOCIAL SECURITY
NUMBER (999-99-9999)

applicable)

4. DATE OF BIRTH

(MM/DD/YYYY)

5. RACE OR ETHNICITY (Optional. You may select more than one. Information will be used for statistical purposes only.)
AMERICAN INDIAN OR ALASKA NATIVE

ASIAN OR ASIAN AMERICAN

NOT HISPANIC OR LATINO

NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER

BLACK OR AFRICAN AMERICAN

WHITE

7. AGE AT TIME OF DEATH (Optional)

6. SEX (Optional. Information will be used for statistical purposes only)
FEMALE

HISPANIC OR LATINO

MALE

8. NAME OF FUNERAL HOME REPRESENTATIVE (If applicable)

10. ADDRESS OF FUNERAL HOME

9. TELEPHONE NUMBER OF FUNERAL HOME ((999) 999-9999)
11. NAME OF APPLICANT

13. ADDRESS OF APPLICANT

12. TELEPHONE NUMBER OF APPLICANT ((999) 999-9999)
14. APPLICANT E-MAIL ADDRESS
15. PLEASE INCLUDE THE FOLLOWING ATTACHMENTS (Please ensure decedent's name and/or DECEDENT ID appears on each attachment.)
SUPPORTING DOCUMENTS REFLECTING NO NEXT-OF-KIN WAS LOCATED
FSC VENDOR FILE REQUEST FORM (VA FORM 10091) If previously enrolled provide Vendor ID:

VA FORM
MAR 2025

40-10088

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By signing below I certify the following:
I. I cannot identify the Veteran's next-of-kin or an identified next of kin is unwilling or unable to assume responsibility for the deceased Veteran's burial
arrangements.
II. I have followed applicable state or local law relating to the disposition of unclaimed remains.
III. To the best of my knowledge, sufficient resources are otherwise unavailable to furnish the casket or urn.
16. SIGNATURE OF PERSON AUTHORIZED TO CERTIFY (Ink signature)

17. DATE (MM/DD/YYYY)

PENALTY: The law provides severe penalties, which include fine or imprisonment, or both, for the willful submission of any statement or evidence
of a material fact, knowing it to be false, or for the fraudulent acceptance of any benefit to which you are not entitled.

PART II - CEMETERY OFFICIAL OBSERVATION OF BURIAL CONTAINER

(For Completion by VA National, State, or Tribal Cemetery Official)

1. BEFORE ALLOWANCE FOR THE CASKET OR URN CAN BE PROCESSED, ALL OF THE FOLLOWING QUALITY STANDARDS FOR THE BURIAL RECEPTABLE
MUST BE OBSERVED:
URN (Must be of durable material. Select one)

CASKET
STANDARD SIZE (Exterior dimensions are generally 82 X 28 inches)

PLASTIC

METAL

CONSTRUCTED OF 20 GAUGE OR THICKER METAL

WOOD

CERAMIC/STONE

IS NOT LEAKING

OTHER

SEALED, NOT LEAKING

HAS FIXED RAILS OR SWING ARM HANDLES
HOLDS THE WEIGHT OF THE DECEDENT'S REMAINS
THE CASKET/URN EXHIBITS ALL OF THE LISTED QUALITY STANDARDS

THE CASKET/URN DOES NOT EXHIBIT ALL OF THE LISTED QUALITY STANDARDS (Please Explain):

2. PRINTED NAME OF VA NATIONAL, STATE, OR TRIBAL CEMETERY OFFICIAL

3. CEMETERY NAME

4. CEMETERY STATION NUMBER

5. CEMETERY STATE

6. SIGNATURE OF VA NATIONAL, STATE OR TRIBAL CEMETERY OFFICIAL (Ink signature)

7. DATE (MM/DD/YYYY)

8. APPLICANT ACKNOWLEDGMENT OF OBSERVATIONS (SIGNATURE) (Ink signature)

9. DATE (MM/DD/YYYY)

VA FORM 40-10088, MAR 2025

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