Veterans' medallion for a privately purchased headstone in a private cemetery

1) Confirm that the deceased is eligible.

Eligibility requirements ask that the deceased was not dishonorably discharged and that one of the below is true:

• Died before November 1, 1990, or

• Served on or after April 6, 1917, or

• Is buried in a privately marked grave

2) Fill out the Claim for Government Medallion for Placement in a Private Cemetery (VA Form 40-1330M)

3) Make a copy of the Veteran’s discharge documents. Don’t send the originals.

4) Fax the form and discharge documents to 1-800-455-7143. Or, mail the discharge papers and the form to this address:

Memorial Products Service (41B)

Department of Veteran Affairs

5109 Russell Road

Quantico, VA 22134-3903

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