Respondent burden notice
OMB Number 2900-0559, expiration date Oct. 31, 2026, an estimated burden of 15 minutes and the statutory authority 38 U.S.C. 2408.
VA40-0895-10
Certification of Compliance with Federal Requirements State or Tribal Government Construction Grant
- Agency
- VA
- Revision
- September 2023
- Fillable fields
- 4
- Pages
- 1
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form VA40-0895-10: Certification of Compliance with Federal Requirements
VA Form VA40-0895-10 is the U.S. Department of Veterans Affairs Certification of Compliance with Federal Requirements, State, Tribal or Eligible County Government Construction Grant (38 CFR Part 39). VA's form page lists it as Certification of Compliance with Federal Requirements State or Tribal Government Construction Grant. It is a grant form, not a benefits form: an authorized State, Tribal or eligible County Government official signs it for a Veterans cemetery construction project.
The official certifies, to the best of their knowledge and belief, that three things have been incorporated into the construction contracts for the project: all Federal requirements outlined in 38 CFR Part 39 as they pertain to the cemetery project, the assurances outlined in SF 424D, and all mandatory comments resulting from VA's design development review. The form gives the statutory authority for a State Cemetery Grant as 38 U.S.C. 2408.
The form is one page, and VA's form page offers the PDF only. 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 VA40-0895-10
Certification
The statement that the 38 CFR Part 39 requirements, the SF 424D assurances and all mandatory comments from VA's design development review have been incorporated into the construction contracts.
Project location and FAI number
Where the State, Tribal or eligible County Government cemetery project is located, and its Project FAI (Federal Application Identifier) number.
Official's name and title
The name and title of the authorized State, Tribal or eligible County Government official.
Signature and date
The signature of the authorized official and the date signed, written as mm/dd/yyyy.
How to complete VA Form VA40-0895-10
- 1
Read the certification
It covers the 38 CFR Part 39 requirements, the SF 424D assurances and the mandatory comments from VA's design development review.
- 2
Enter the project
Fill in where the cemetery project is located and its Project FAI (Federal Application Identifier) number.
- 3
Name the official
Enter the name and title of the authorized State, Tribal or eligible County Government official.
- 4
Sign and date it
The authorized official signs and enters the date signed as mm/dd/yyyy.
Why fill Form VA40-0895-10 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the VA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes
No address on the form
VA Form VA40-0895-10 prints no mailing address, email or fax number for the completed certification. VA's form page offers the PDF only.
Comments only
The burden notice lists the OIRA Desk Officer for VA, 725 17th St NW, Washington, DC 20503, and says SEND COMMENTS ONLY. Please do not send applications for a grant to this address.
Edition
The footer reads VA FORM SEP 2023 40-0895-10, and VA's form page lists a revision date of September 2023. OMB Number 2900-0559 has an expiration date of Oct. 31, 2026.
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Who uses VA Form VA40-0895-10?
The form is completed for a cemetery construction grant, not by individual Veterans.
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Questions about Form VA40-0895-10
Who signs VA Form VA40-0895-10?
An authorized State, Tribal or eligible County Government official, who also gives their name and title.
What does the official certify?
That all Federal requirements in 38 CFR Part 39 as they pertain to the project, the assurances outlined in SF 424D and all mandatory comments from VA's design development review have been incorporated into the construction contracts.
Which rules does the form refer to?
It refers to 38 CFR Part 39 and the SF 424D assurances, and it gives the statutory authority for a State Cemetery Grant as 38 U.S.C. 2408.
What is the Project FAI number?
The form labels the field PROJECT FAI (Federal Application Identifier) NO. It sits next to the project location.
Is VA Form VA40-0895-10 for Veterans or families?
No. It is a certification for a State, Tribal or eligible County Government cemetery construction grant project, signed by an authorized government official.
Where is the completed form sent?
The form prints no address for it. The Washington, DC address in the burden notice is for comments only, and the form says not to send grant applications there.