Items 1 to 4: policy and payment
The insurance policy number, net amount payable, the beneficiary's share as a fraction and the payment option selected by the insured.
29-4125a
Claim for Monthly Payments—National Service Life Insurance
- Agency
- VA
- Revision
- December 2024
- Fillable fields
- 27
- Pages
- 2
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 29-4125a: Claim for Monthly Payments, National Service Life Insurance
VA Form 29-4125a is the U.S. Department of Veterans Affairs Claim for Monthly Payments for National Service Life Insurance. The form says it is to be used only when monthly payments were selected by the insured, or the beneficiary is selecting monthly payments instead of one sum. It is used for all policies where the claimant is listed as a beneficiary for monthly installments, unless a separate form for a Lump Sum Payment is sent for a policy.
The form is two pages. Page 1 holds the policy and beneficiary details, the selection of option, the beneficiary's signature and the direct deposit details. Page 2 holds the instructions for selection of optional settlement, where to send the form and the Privacy Act and respondent burden notices.
VA's form page lists VA Form 29-4125, Claim for One Sum Payment, as a related form. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form 29-4125a
Items 5 to 13: insured and beneficiary
The insured Veteran's name, date of birth and place of death, then the beneficiary's name, relationship to the insured, date of birth, address, daytime phone, email and Social Security number.
Item 14: selection of option
Option 2, monthly installments for 36 to 240 months in multiples of 12; Option 3, lifetime installments with 120 payments guaranteed; and Option 4, lifetime installments guaranteeing at least the beneficiary's share. Options 3 and 4 ask for proof of age.
Items 15 and 16: signature
The signature of the beneficiary, fiduciary or guardian and the date signed. The form says settlement under one of the options is full and complete settlement of all liability under the contract.
Direct deposit
Name, address and phone of the financial institution, the routing transit number, checking or savings, and the depositor account number, completed by the beneficiary if direct deposit is desired.
Page 2: settlement instructions
Six numbered instructions on which options the beneficiary may choose depending on the insured's selection, minimum installment amounts, and who receives remaining guaranteed installments.
How to file VA Form 29-4125a
- 1
Read the page 2 instructions
The form says to read the instructions on page 2 and consult the attached tables before making a selection.
- 2
Fill in Items 1 to 13
Type or print in ink, as the form asks, the policy, insured and beneficiary details.
- 3
Select an option in Item 14
Check the box for the option selected, or more than one box in line with Instruction 2. For Option 2, the form asks for all items on the line checked.
- 4
Attach proof of death and age
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 proof of age such as a driver's license or birth certificate for Options 3 and 4.
- 5
Sign Item 15
The beneficiary, guardian or fiduciary signs Item 15 and dates Item 16. Add bank details if direct deposit is desired.
- 6
Upload or mail it
Send the completed form through VA's secure upload service or mail it to the Insurance Center in Janesville, Wisconsin.
Why fill Form 29-4125a on indox
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Where to send it
Upload
The form lists VA's secure upload service at https://insurance.va.gov/home/IDU.
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 this form or 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
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Claim for One Sum Payment—Government Life Insurance
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Certificate Showing Residence and Heirs of Deceased Veteran or Beneficiary
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29-336
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29-336a
Supplemental Designation of Beneficiary—Government Life Insurance
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29-0309
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29-0975
Authorization to Disclose Personal Information to a Third Party (Insurance)
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Who uses VA Form 29-4125a?
The form and its instructions describe who completes and signs it.
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Questions about Form 29-4125a
When is VA Form 29-4125a used?
The form says only when monthly payments were selected by the insured, or the beneficiary is selecting monthly payments instead of one sum.
Can a beneficiary take a lump sum instead?
The form says Option 1, lump sum settlement, is not available when the insured selected a monthly installment option. If the insured left a will or other written evidence of wanting a lump sum, the beneficiary may submit a copy and sign Item 15.
What if the beneficiary does not choose an option?
The form says settlement will be based on the option selected by the insured.
Is there a minimum monthly installment?
Instruction 5 says installments of less than $10 are paid under Option 2 in the number of installments, in multiples of 12, that gives a monthly installment of not less than $10. If the value cannot pay at least twelve such installments, it is paid in one sum.
Can the payment be split between two options?
Instruction 2 lists when a beneficiary may split settlement. The form says that with two methods of payment, the amount under at least one must be in multiples of $1000 and all monthly installments at least $10.
What if the beneficiary dies before all installments are paid?
Instruction 6 says the commuted value of the remaining guaranteed installments goes to the estate of the beneficiary if the insured selected Option 1, or to the estate of the insured if the insured designated Option 2, 3 or 4 and all beneficiaries die.