Va Form 27-2008 - Application For United States Flag For Burial Purposes

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OMB Control No. 2900-0013
Respondent Burden: 15 Minutes
Expiration Date: 3-31-2018
APPLICATION FOR UNITED STATES FLAG FOR BURIAL PURPOSES
PRIVACY ACT NOTICE: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine
uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the United States, litigation in which the United States is a party or has an
interest, the administration of VA programs and delivery of VA benefits, verification of identity and status, and personnel administration) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension,
Education, and Vocational Rehabilitation and Employment Records - VA, published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. Giving us the veteran's SSN account information
is voluntary. Refusal to provide the veteran's SSN by itself will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by
a Federal Statute of law in effect prior to January 1, 1975, and still in effect. The requested information is considered relevant and necessary to determine entitlement to benefits under the law. The responses you submit are
considered confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching programs with other agencies.
RESPONDENT BURDEN: We need this information to determine eligibility for issuance of a burial flag to a family member or friend of a deceased veteran (38 U.S.C. 2301). Title 38, United States Code, allows us to ask
for this information. We estimate that you will need an average of 15 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid
OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at
If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.
IMPORTANT - Postmaster or other issuing official: Submit this form to the nearest VA regional office. Be sure to complete the stub at the bottom.
INFORMATION ABOUT THE DECEASED VETERAN (Complete as much as possible)
(Information provided is considered essential when applying for other VA benefits.)
2. MAIDEN NAME OR OTHER NAME(S) VETERAN USED WHILE ON ACTIVE DUTY
(Print or type)
1. FIRST, MIDDLE, LAST NAME OF VETERAN
(Print or type)
3. VA FILE NUMBER
4. SOCIAL SECURITY NUMBER
5. MILITARY SERVICE NUMBER/SERIAL NUMBER
(Check box)
6. BRANCH OF SERVICE
(Specify)
ARMY
NAVY
AIR FORCE
MARINE CORPS
COAST GUARD
SELECTED SERVICE
OTHER
(or Selected
(or
9. DATE OF BIRTH
10. DATE OF DEATH
7. DATE ENTERED ACTIVE DUTY
8. DATE RELEASED FROM ACTIVE DUTY
Reserve)
Selected Reserve)
(Name of cemetery, city, and State)
11. DATE OF BURIAL
12. PLACE OF BURIAL
(See Paragraphs C, D, and E of
13. HAS DOCUMENTATION BEEN PRESENTED OR ATTACHED THAT SHOWS THE VETERAN MEETS THE ELIGIBILITY CRITERIA?
the "Instructions")
(If "No," explain in Item 15, "Remarks" (See paragraph E of the "Instructions"))
YES
NO
INFORMATION ABOUT THE FLAG RECIPIENT AND APPLICANT
(See Paragraph F of the "Instructions")
14A. NAME OF PERSON ENTITLED TO RECEIVE FLAG
14B. RELATIONSHIP OF DECEASED VETERAN
(Number and street or rural route, city or P.O., State and ZIP Code)
14C. ADDRESS OF PERSON ENTITLED TO RECEIVE FLAG
14D. TELEPHONE NUMBER
15. REMARKS
I CERTIFY that the statements made in this document are true and complete to the best of my knowledge. I further certify that the deceased veteran is eligible, in
accordance with the attached instructions, for issue of a United States flag for burial purposes, and such flag has not been previously applied for or furnished.
(Number and street or
17. ADDRESS OF APPLICANT
(Sign in INK)
18. RELATIONSHIP TO
16. SIGNATURE OF APPLICANT
19. DATE SIGNED
rural route, city or P.O., and ZIP Code)
DECEASED VETERAN
PENALTY - The law provides that whoever makes any statement of a material fact knowing it to be false shall be punished by a fine, imprisonment, or both.
ACKNOWLEDGMENT OF RECEIPT OF FLAG (ONLY ONE FLAG MAY BE ISSUED FOR EACH DECEASED VETERAN)
(Sign in INK)
20. SIGNATURE OF PERSON RECEIVING FLAG
21. DATE FLAG ISSUED
FOR VA USE
22. NAME AND ADDRESS OF POST OFFICE OR OTHER FLAG ISSUE POINT
DATE NOTIFICATION
STATION NUMBER
FORWARDED TO SUPPLY
VA FORM 27-2008, MAR 2015
SUPERSEDES VA FORM 27- 2008, JUL 2012, WHICH WILL NOT BE USED.
This stub is to be completed by the POSTMASTER or other issuing official. Upon receipt the VA Regional Office will detach and forward it to
the appropriate Supply Officer.
NOTIFICATION OF ISSUANCE OF FLAG
DATE FLAG ISSUED
ISSUING POINT TELEPHONE NO.
ADDRESS OF POST OFFICE OR OTHER FLAG ISSUE POINT
SIGNATURE OF POSTMASTER OR OTHER ISSUING OFFICIAL
VA FORM
27-2008
SUPERSEDES VA FORM 27- 2008, JUL 2012,
SEE INSTRUCTIONS
MAR 2015
WHICH WILL NOT BE USED.

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