VA40-1330UP

Claim for Commemorative Urn or Plaque for Veterans’ Cremains Not Interred

Agency
VA
Revision
March 2025
Fillable fields
29
Pages
2
Official source
VA form page
Checked
October 20, 2026
Fill VA40-1330UP online
Page 1 of form VA40-1330UP

VA Form VA40-1330UP: Commemorative Urn or Plaque for Veterans' Cremains Not Interred

VA Form VA40-1330UP is the U.S. Department of Veterans Affairs Claim for Commemorative Urn or Plaque for Veterans' Cremains Not Interred. VA's form page says to use it if you're a family member and want to request a commemorative plaque or urn for a Veteran who has been cremated. The form covers a Veteran cremated with no portion of the remains interred at any location at the time of application, and defines interment as the burial or entombment of casketed or cremated remains, including the placement of cremated remains in a columbarium niche.

The form says a commemorative urn or plaque may only be provided in lieu of other benefits that will be forfeited. If VA provides one, the form says VA is prohibited from interring the Veteran in a VA national cemetery or providing a headstone, marker or medallion for the grave, and it may also affect interment in other cemeteries, including Arlington National Cemetery.

The PDF is two pages: a General Information Sheet and the claim in blocks 1 to 14. 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 VA40-1330UP: Commemorative Urn or Plaque for Veterans' Cremains Not Interred, as printed by VA

What's on VA Form VA40-1330UP

Block 1: plaque or urn

The type of product requested, a plaque or an urn.

Blocks 2 to 9: the Veteran

The name to be commemorated, Social Security or service number, place of birth, race or ethnicity and sex for statistical purposes only, dates of birth and death, dates entered and separated, and one branch of service.

Block 10: the applicant

The applicant's name and mailing address, daytime phone number and email address. VA ships the urn or plaque to the applicant named in block 10a.

Block 11: benefits forfeited

The notice on the benefits given up in lieu of a commemorative urn or plaque and the possible effect on interment in other cemeteries.

Blocks 12 to 14: certification

The applicant certifies the remains were cremated and are not interred, enters their full name and familial relationship, certifies they understand the forfeited benefits and hold the entirety of the remains, then signs and dates.

The urn and the plaque

The information sheet describes a walnut urn 7.125 inches high, 7.25 inches wide and 9.25 inches long, and a walnut plaque 10 inches long, 8 inches wide and 3/4 of an inch thick, each with a folded flag emblem and a brass inscription.

How to file VA Form VA40-1330UP

  1. 1

    Read the information sheet and block 11

    The form says it is critical that the family member consider the final disposition of the Veteran's remains and be certain of their decision before completing the application.

  2. 2

    Choose a plaque or an urn

    Check one product in block 1 and select one branch of service in block 9. The form says only one branch of service may be selected.

  3. 3

    Fill in the details

    Type or print clearly all information except signatures. Give a full delivery address and telephone number in block 10, as the form says VA will not deliver to a Post Office box.

  4. 4

    Attach service documents

    Attach a copy of the discharge certificate (DD Form 214 or equivalent), the VA Pre-Need Eligibility Determination letter or other official documents. The form says not to send originals, as they will not be returned.

  5. 5

    Certify, sign and submit

    Complete the block 12 certification, sign block 13 and date block 14, then submit through Quick Submit or by mail.

Why fill Form VA40-1330UP on indox

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Where to send it and getting help

Online

The form says to submit the claim and supporting documents electronically using Quick Submit at access.va.gov, where you are instructed to register during your first sign-on attempt.

By mail

NCA FP Evidence Intake Center, PO Box 5237, Janesville, WI 53547.

Delivery

VA ships the urn or plaque without charge to the applicant in block 10a. The form says a signature will be required on receipt, and that unless the urn or plaque was damaged during shipping, VA will not replace it.

Questions

The form lists the Applicant Assistance Unit toll free at 1-800-697-6947, or ask.va.gov. It says no fee should be paid in connection with the preparation of this claim.

Edition

The current edition is dated MAR 2025. It carries OMB Approved No. 2900-0937, with an expiration date of 05/31/2027.

Related forms

Who uses VA Form VA40-1330UP?

  • The family member holding the remains

    The form says the applicant is the family member who holds the entirety of the cremated remains and is authorized to make decisions about the disposition of the Veteran.

  • Who counts as family

    The decedent's spouse or individual in a legal union with the decedent, a child, parent or sibling, whether biological, adopted or step relation, and any lineal or collateral descendant.

  • Veterans and Servicemembers commemorated

    The form describes a deceased Veteran cremated with no portion of the remains interred, discharged under conditions other than dishonorable on or after April 6, 1917, or a Servicemember who died on active duty whose cremated remains are not interred.

  • Families thinking about future interment

    The form encourages potential applicants who might seek interment in the future to check directly with other cemeteries regarding its effect on potential interment at those cemeteries.

The General Information Sheet says who may apply and which Veterans the urn or plaque commemorates.

Official sources and the blank

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Questions about Form VA40-1330UP

Who can use VA Form VA40-1330UP?

VA's form page says to use it if you're a family member and want to request a commemorative plaque or urn for a Veteran who has been cremated. The form says the applicant is the family member who holds the entirety of the cremated remains and is authorized to make decisions about their disposition.

Which benefits are given up?

The form says that if VA provides an urn or plaque, VA is prohibited from interring the Veteran or Servicemember in a VA national cemetery or providing a headstone or marker or medallion that would mark the grave. It may also affect interment in other cemeteries, including Arlington National Cemetery.

Does a columbarium niche count as interment?

Yes. The form defines interment as the burial or entombment of casketed or cremated remains, including the placement of cremated remains in a columbarium niche.

What is inscribed on the urn or plaque?

The form says each has a 5-inch etched emblem of a folded flag with the words Veteran and the branch of service, and a black plate with a brass inscription of the Veteran's name, date of birth and date of death.

Can I select more than one branch of service?

No. Block 9 says to select one, and the information sheet says only one branch of service may be selected.

How do I submit VA Form VA40-1330UP?

The form lists Quick Submit at access.va.gov, or mail to NCA FP Evidence Intake Center, PO Box 5237, Janesville, WI 53547. It does not list a fax number.