29-4125

Claim for One Sum Payment—Government Life Insurance

Agency
VA
Revision
December 2024
Fillable fields
48
Pages
3
Official source
VA form page
Checked
October 20, 2026
Fill 29-4125 online
Page 1 of form 29-4125

VA Form 29-4125: Claim for One Sum Payment, Government Life Insurance

VA Form 29-4125 is the U.S. Department of Veterans Affairs Claim for One Sum Payment for Government Life Insurance. A beneficiary uses it to claim a lump sum payment of a deceased Veteran's life insurance. The form says it should be used to submit all Veterans' Life Insurance claims except Servicemember's Group Life Insurance (SGLI), Family Servicemember's Group Life Insurance (FSGLI) and Veteran's Group Life Insurance (VGLI).

The form is three pages. Every claimant completes Section I on the deceased Veteran, Section VI on financial information and Section VII, the signature and certification. In between, individual beneficiaries complete Section II, trusts Section III, probated estates Section IV, and organizations, charities or other legal entities Section V. The form asks for a photocopy of the Veteran's death certificate or a statement from the attending physician showing date and cause of death.

VA's form page lists VA Form 29-4125a, Claim for Monthly Payments, as a related form. You can fill out the PDF free in your browser on this page and download the result without an account.

Top of page 1 of VA Form 29-4125: Claim for One Sum Payment, Government Life Insurance, as printed by VA

What's on VA Form 29-4125

Section I: deceased Veteran

Name of the insured Veteran, Social Security number, insurance policy number and date of death. The form says all information in this section is required.

Section II: individual beneficiary

Name, Social Security number, date of birth, relationship to the insured, a mailing address the form marks as required, email and daytime phone.

Sections III to V: trust, estate or organization

Name of the trust, estate or entity, the trustee, executor or administrator, or authorized representative, mailing address, phone, email and EIN or TIN, plus the trust agreement date for trusts.

Section VI: financial information

Name of the financial institution, checking or savings, the nine-digit routing number and the account number for electronic funds transfer, with a sample check showing where to find them.

Section VII: signature and certification

Signature of the beneficiary, guardian, attorney-in-fact or fiduciary, or of the trustee, executor or representative, the date signed, and two witness blocks for a signature made with an X.

How to file VA Form 29-4125

  1. 1

    Gather the death certificate

    The form asks for a photocopy of the Veteran's death certificate or an attending physician's statement showing date and cause of death, and copies for any deceased beneficiaries if applicable.

  2. 2

    Complete Section I

    Enter the deceased Veteran's name, Social Security number, insurance policy number and date of death.

  3. 3

    Complete the beneficiary section

    Section II for an individual, Section III for a trust, Section IV for a probated estate or Section V for an organization, with the documents that section lists.

  4. 4

    Enter bank details

    The form says the Department of Treasury has mandated electronic funds transfer and the account is in the name of the designated beneficiary. It says not to use a deposit slip to find the details.

  5. 5

    Sign and date Section VII

    Sign Item 36 and date Item 37. If signing with an X, two impartial witnesses fill in Items 38 and 39.

  6. 6

    Upload or mail it

    Send the form through VA's document upload service or mail it to the Insurance Center in Janesville, Wisconsin.

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Where to send it

Document upload

The form lists VA's secure upload website at https://insurance.va.gov/home/IDU.

By mail

Department of Veterans Affairs Insurance Center, PO Box 5209, Janesville, WI 53547-5209.

Questions

The form lists the toll free number 1-800-669-8477 for questions about your Government Life Insurance.

Edition

The December 2024 edition supersedes the February 2022 edition, which the form says will not be used. It carries OMB Approved No. 2900-0060, which expires 12/31/2027.

Related forms

Who uses VA Form 29-4125?

  • Individual beneficiaries

    A person named as beneficiary completes Section II, then skips to Section VI. The form says one claim form is used for every policy of the Veteran on which they are listed for a lump sum payment.

  • Trusts

    Section III is for a trust. The form asks for a copy of the trust agreement and a voided check or bank statement for the trust, and for testamentary trusts the Will and court appointment documents.

  • Probated estates

    Section IV names the court-appointed executor or administrator and asks for the court's appointment papers. For an estate that is not probated, the form points to VA Form 29-541 instead.

  • Organizations, charities and legal entities

    Section V names an authorized representative, and the form asks for letters of resolution or authority authorizing that person to act or sign for the organization.

  • Guardians and custodians

    For a minor or incompetent beneficiary, the person having custody completes the form. The form says VA cannot issue payment directly to a minor and pays a court-appointed guardian or VA fiduciary.

  • Not for SGLI, FSGLI or VGLI

    The form says it is not used for Servicemember's Group Life Insurance, Family Servicemember's Group Life Insurance or Veteran's Group Life Insurance claims.

The form's instructions say which section each type of beneficiary completes.

Official sources and the blank

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Questions about Form 29-4125

Which claims use VA Form 29-4125?

The form says it should be used to submit all Veterans' Life Insurance claims except SGLI, FSGLI and VGLI.

What documents go with the claim?

A photocopy of the Veteran's death certificate or a statement from the attending physician showing date and cause of death. Trusts, estates and organizations also attach the documents their sections list.

Can VA pay a minor beneficiary directly?

No. The form says payment is made to a court-appointed guardian or VA fiduciary, and VA will request appointment of a VA fiduciary if no guardian is in place.

What if the estate is not probated?

The form says to complete VA Form 29-541, Certificate Showing Residence and Heirs of Deceased Veteran or Beneficiary, instead. VA will notify each entitled heir to complete a VA Form 29-4125 once the heirs have been determined.

How is the payment made?

By electronic funds transfer. Section VI asks for the bank's name, account type, routing number and account number, in the name of the designated beneficiary.

Can the form be signed with an X?

The form says an X is acceptable if the beneficiary cannot sign but is competent to handle his or her own affairs, when witnessed by two impartial people.

Is there a form for monthly payments?

VA's form page lists VA Form 29-4125a, Claim for Monthly Payments, National Service Life Insurance, as a related form.