VA Form 40-1330M

Claim for Government Medallion for Private Cemetery Marker

Burial & MemorialOfficial VA form on VA.gov

Who fills it

next-of-kin

Journey phase

Burial & Memorial

Estimated time

15-20 minutes.

When to file

Anytime after burial. No deadline.

The veteran already has a private headstone in a private cemetery and you want to add a bronze veteran's medallion to it rather than replacing the existing marker.

Gather before you start

—Veteran's full name and service information (DD-214)

—Photo of the existing private headstone

—Medallion size preference (large, medium, or small)

—Cemetery contact for delivery

Attach with the form

—Photo of existing headstone showing it is already in place

—DD-214 or service records if not on file

Section I - Person Requesting Medallion

1 field

Blocks 1-4Your name, address, phone, relationship to veteranPII

Your contact information. Include a reliable phone number - VA may contact you about sizing or delivery.

Example

(name, address, phone, relationship)

Common mistakes

Not providing a valid phone number - VA cannot reach you with questions.

Section II - Veteran and Service Information

1 field

Blocks 5-12Veteran name, branch, service dates, DOB, DODPII

VA verifies eligibility against service records. The veteran must be an eligible veteran (wartime or peacetime service depending on discharge character). All information should match the DD-214.

Example

(veteran name, U.S. ARMY, 1968-1970, DOB/DOD)

Common mistakes

Assuming all veterans qualify regardless of discharge - generally requires honorable or general discharge.

Section III - Medallion Size

1 field

Block 13Preferred medallion size

Available in three sizes: (1) LARGE - 5 inches; (2) MEDIUM - 3.5 inches; (3) SMALL - 2 inches. Choose based on the size of the existing headstone. The medallion is bronze and attaches to the front face of the marker.

Example

e.g., Large (5 inch)

Common mistakes

Ordering a large medallion for a small flat marker - measure the existing headstone first.
Not knowing the medallion says "UNITED STATES VETERAN" on the outside ring and has the branch emblem in the center.

Section IV - Existing Headstone

1 field

Block 14Confirm existing privately purchased marker is in place

VA requires a photograph of the existing marker to confirm it is in place before issuing a medallion. Attach a clear photo showing the headstone in the cemetery.

Example

(attach photo of existing headstone)

Common mistakes

Not attaching the photo - VA will return the request.
Ordering a medallion for a grave that does not yet have a marker - use 40-1330 for a full marker instead.

Section V - Delivery Address

1 field

Blocks 15-18Cemetery or family address for delivery

VA can ship to the cemetery directly or to the family. Shipping to the family is often easier since the family then arranges with the cemetery for installation. Unlike full headstones, medallions can be shipped to a home address.

Example

e.g., Ship to family: Jane Smith, 123 Main St, Phoenix AZ 85001

Common mistakes

Having it shipped to a cemetery that then misplaces or loses the package - shipping to family is often safer.

Section VI - Certification

1 field

Blocks 19-20Requestor signature and datePII

Sign and date under penalty of perjury.

Example

(your signature/date)

Common mistakes

Forgetting to sign.

Statutory & regulatory authority

38 CFR 38.630 - Eligibility for a Government-furnished headstone, marker, or medallion to mark the grave of an eligible veteran.

38 USC 2306 - Authority for VA to furnish headstones, markers, and medallions at no cost.

VA Form 40-1330M

Claim for Government Medallion for Private Cemetery Marker

Burial & MemorialOfficial VA form on VA.gov

Who fills it

next-of-kin

Journey phase

Burial & Memorial

Estimated time

15-20 minutes.

When to file

Anytime after burial. No deadline.

The veteran already has a private headstone in a private cemetery and you want to add a bronze veteran's medallion to it rather than replacing the existing marker.

Gather before you start

—Veteran's full name and service information (DD-214)

—Photo of the existing private headstone

—Medallion size preference (large, medium, or small)

—Cemetery contact for delivery

Attach with the form

—Photo of existing headstone showing it is already in place

—DD-214 or service records if not on file

Section I - Person Requesting Medallion

1 field

Blocks 1-4Your name, address, phone, relationship to veteranPII

Your contact information. Include a reliable phone number - VA may contact you about sizing or delivery.

Example

(name, address, phone, relationship)

Common mistakes

Not providing a valid phone number - VA cannot reach you with questions.

Section II - Veteran and Service Information

1 field

Blocks 5-12Veteran name, branch, service dates, DOB, DODPII

VA verifies eligibility against service records. The veteran must be an eligible veteran (wartime or peacetime service depending on discharge character). All information should match the DD-214.

Example

(veteran name, U.S. ARMY, 1968-1970, DOB/DOD)

Common mistakes

Assuming all veterans qualify regardless of discharge - generally requires honorable or general discharge.

Section III - Medallion Size

1 field

Block 13Preferred medallion size

Example

e.g., Large (5 inch)

Common mistakes

Ordering a large medallion for a small flat marker - measure the existing headstone first.
Not knowing the medallion says "UNITED STATES VETERAN" on the outside ring and has the branch emblem in the center.

Section IV - Existing Headstone

1 field

Block 14Confirm existing privately purchased marker is in place

VA requires a photograph of the existing marker to confirm it is in place before issuing a medallion. Attach a clear photo showing the headstone in the cemetery.

Example

(attach photo of existing headstone)

Common mistakes

Not attaching the photo - VA will return the request.
Ordering a medallion for a grave that does not yet have a marker - use 40-1330 for a full marker instead.

Section V - Delivery Address

1 field

Blocks 15-18Cemetery or family address for delivery

Example

e.g., Ship to family: Jane Smith, 123 Main St, Phoenix AZ 85001

Common mistakes

Having it shipped to a cemetery that then misplaces or loses the package - shipping to family is often safer.

Section VI - Certification

1 field

Blocks 19-20Requestor signature and datePII

Sign and date under penalty of perjury.

Example

(your signature/date)

Common mistakes

Forgetting to sign.

Statutory & regulatory authority

38 CFR 38.630 - Eligibility for a Government-furnished headstone, marker, or medallion to mark the grave of an eligible veteran.

38 USC 2306 - Authority for VA to furnish headstones, markers, and medallions at no cost.

VA Form 40-1330M

Claim for Government Medallion for Private Cemetery Marker

Burial & MemorialOfficial VA form on VA.gov

Who fills it

next-of-kin

Journey phase

Burial & Memorial

Estimated time

15-20 minutes.

When to file

Anytime after burial. No deadline.

The veteran already has a private headstone in a private cemetery and you want to add a bronze veteran's medallion to it rather than replacing the existing marker.

Gather before you start

—Veteran's full name and service information (DD-214)

—Photo of the existing private headstone

—Medallion size preference (large, medium, or small)

—Cemetery contact for delivery

Attach with the form

—Photo of existing headstone showing it is already in place

—DD-214 or service records if not on file

Section I - Person Requesting Medallion

1 field

Blocks 1-4Your name, address, phone, relationship to veteranPII

Your contact information. Include a reliable phone number - VA may contact you about sizing or delivery.

Example

(name, address, phone, relationship)

Common mistakes

Not providing a valid phone number - VA cannot reach you with questions.

Section II - Veteran and Service Information

1 field

Blocks 5-12Veteran name, branch, service dates, DOB, DODPII

VA verifies eligibility against service records. The veteran must be an eligible veteran (wartime or peacetime service depending on discharge character). All information should match the DD-214.

Example

(veteran name, U.S. ARMY, 1968-1970, DOB/DOD)

Common mistakes

Assuming all veterans qualify regardless of discharge - generally requires honorable or general discharge.

Section III - Medallion Size

1 field

Block 13Preferred medallion size

Example

e.g., Large (5 inch)

Common mistakes

Ordering a large medallion for a small flat marker - measure the existing headstone first.
Not knowing the medallion says "UNITED STATES VETERAN" on the outside ring and has the branch emblem in the center.

Section IV - Existing Headstone

1 field

Block 14Confirm existing privately purchased marker is in place

VA requires a photograph of the existing marker to confirm it is in place before issuing a medallion. Attach a clear photo showing the headstone in the cemetery.

Example

(attach photo of existing headstone)

Common mistakes

Not attaching the photo - VA will return the request.
Ordering a medallion for a grave that does not yet have a marker - use 40-1330 for a full marker instead.

Section V - Delivery Address

1 field

Blocks 15-18Cemetery or family address for delivery

Example

e.g., Ship to family: Jane Smith, 123 Main St, Phoenix AZ 85001

Common mistakes

Having it shipped to a cemetery that then misplaces or loses the package - shipping to family is often safer.

Section VI - Certification

1 field

Blocks 19-20Requestor signature and datePII

Sign and date under penalty of perjury.

Example

(your signature/date)

Common mistakes

Forgetting to sign.

Statutory & regulatory authority

38 CFR 38.630 - Eligibility for a Government-furnished headstone, marker, or medallion to mark the grave of an eligible veteran.

38 USC 2306 - Authority for VA to furnish headstones, markers, and medallions at no cost.

VA Form 40-1330M

Claim for Government Medallion for Private Cemetery Marker

Burial & MemorialOfficial VA form on VA.gov

Who fills it

next-of-kin

Journey phase

Burial & Memorial

Estimated time

15-20 minutes.

When to file

Anytime after burial. No deadline.

The veteran already has a private headstone in a private cemetery and you want to add a bronze veteran's medallion to it rather than replacing the existing marker.

Gather before you start

—Veteran's full name and service information (DD-214)

—Photo of the existing private headstone

—Medallion size preference (large, medium, or small)

—Cemetery contact for delivery

Attach with the form

—Photo of existing headstone showing it is already in place

—DD-214 or service records if not on file

Section I - Person Requesting Medallion

1 field

Blocks 1-4Your name, address, phone, relationship to veteranPII

Your contact information. Include a reliable phone number - VA may contact you about sizing or delivery.

Example

(name, address, phone, relationship)

Common mistakes

Not providing a valid phone number - VA cannot reach you with questions.

Section II - Veteran and Service Information

1 field

Blocks 5-12Veteran name, branch, service dates, DOB, DODPII

VA verifies eligibility against service records. The veteran must be an eligible veteran (wartime or peacetime service depending on discharge character). All information should match the DD-214.

Example

(veteran name, U.S. ARMY, 1968-1970, DOB/DOD)

Common mistakes

Assuming all veterans qualify regardless of discharge - generally requires honorable or general discharge.

Section III - Medallion Size

1 field

Block 13Preferred medallion size

Example

e.g., Large (5 inch)

Common mistakes

Ordering a large medallion for a small flat marker - measure the existing headstone first.
Not knowing the medallion says "UNITED STATES VETERAN" on the outside ring and has the branch emblem in the center.

Section IV - Existing Headstone

1 field

Block 14Confirm existing privately purchased marker is in place

VA requires a photograph of the existing marker to confirm it is in place before issuing a medallion. Attach a clear photo showing the headstone in the cemetery.

Example

(attach photo of existing headstone)

Common mistakes

Not attaching the photo - VA will return the request.
Ordering a medallion for a grave that does not yet have a marker - use 40-1330 for a full marker instead.

Section V - Delivery Address

1 field

Blocks 15-18Cemetery or family address for delivery

Example

e.g., Ship to family: Jane Smith, 123 Main St, Phoenix AZ 85001

Common mistakes

Having it shipped to a cemetery that then misplaces or loses the package - shipping to family is often safer.

Section VI - Certification

1 field

Blocks 19-20Requestor signature and datePII

Sign and date under penalty of perjury.

Example

(your signature/date)

Common mistakes

Forgetting to sign.

Statutory & regulatory authority

38 CFR 38.630 - Eligibility for a Government-furnished headstone, marker, or medallion to mark the grave of an eligible veteran.

38 USC 2306 - Authority for VA to furnish headstones, markers, and medallions at no cost.