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THE

PAPER Important Documents for Veterans and Their Loved Ones

SAFE

VETERANS: Do Your Loved Ones Have All the Information They’ll Need To Receive the Benefits You Have Earned?

© 2002, 2012, 2016, 2019. Associates of Vietnam Veterans of America. All rights reserved. Written by Nancy Switzer. Design by Citizen X Design. Some information for this publication was taken from the Federal Benefits for Veterans and Dependents, published by the Department of Veterans Affairs, 2000 Edition. For more information, call your VA Regional Office at 1-800-827-1000 or visit www.va.gov

BURIAL BENEFITS U.S. DEPARTMENT OF VETERANS AFFAIRS The National Cemetery Administration (NCA), a division of the Department of Veterans Affairs (VA), provides burial benefits, which include a gravesite, a headstone or marker, a burial flag and Presidential Memorial Certificate, opening and closing of the grave, and perpetual care in a VA national cemetery. To be eligible for burial benefits, veterans must have been discharged or separated from military service under conditions other than dishonorable, and must have completed their required period of service. Currently there are 137 national cemeteries located in 40 states and Puerto Rico. Spouses and minor children of eligible veterans and service personnel may be buried in a national cemetery, as may certain adult children who are incapable of supporting themselves. These eligible spouses and dependents may be buried in a national cemetery even if they predecease the Veteran. Gravesites may not be reserved; funeral directors or others making the arrangements must apply for the site after the veteran’s death. For more information on benefits from the NCA, see: http://www.cem.va.gov STATE VETERANS CEMETERIES In addition to VA national cemeteries, most states maintain veterans cemeteries for their eligible veterans. For information on state cemeteries, contact the State Veterans’ Services Office in your state, or see: http://www.nasdva.net

by paid bill receipts. The VA will reimburse up to $2,000 ($1,500 if death is prior to September 10, 2001), provided that the cause of death has been adjudicated as service-connected. For non-service-connected deaths, VA will pay up to $300 toward burial and funeral expenses and a $300 plot-interment allowance for deaths on or after December 1, 2001. The plot-interment allowance is $150 for deaths prior to December 1, 2001. If the death happened while the veteran was in a VA hospital or under VA-contracted nursing home care, some or all of the costs for transporting the veteran’s remains may be reimbursed. Even if buried in a private cemetery, veterans may receive a headstone, marker or medallion, a burial flag, and a Presidential Memorial Certificate, at no cost to the family. For more information, contact an accredited veteran service officer, or call the VBA at 800-827-1000.

SURVIVORS’ BENEFITS

The VA administers two types of benefits for the survivors of veterans, depending upon whether the cause of death is service-connected or non-serviceconnected. This is limited to minor children or children who became incapable of self-support at age 18. This includes adopted children. Service-connected death compensation is called Dependency and Indemnity Compensation or “DIC.” It provides monthly payments to the surviving spouse and children of a veteran whose death is determined to be service-connected. To be eligible, the veteran must have died as the result of:

ARLINGTON NATIONAL CEMETERY Arlington National Cemetery in Virginia is maintained by the Department of the Army. Please call 877-9078585 for information concerning burial availability, eligibility and application procedures.

1) A disease or injury incurred or aggravated while on active duty, or

BURIAL AT SEA For Burial at Sea, please call 866-787-0081 or visit htttp://www.navy.mil/navydata/questions/burial.html

3) A disability that the VA can pay compensation benefits for.

REIMBURSEMENT OF PRIVATE CEMETERY BURIAL EXPENSES The Veterans Benefits Administration (VBA) will reimburse funeral expenses paid by the family or funeral home upon receipt of an application and accompanied

2) An injury incurred or aggravated in the line of duty, while on active duty or inactive duty for training, or

The veteran’s death may not be the result of willful misconduct. Furthermore, if the veteran’s spouse remarries, he or she will lose eligibility to receive unless the surviving spouse remarries on or after December 16, 2003, and on or after attaining age 57. In addition, DIC payments may be authorized to the spouse and children of totally disabled veterans

whose deaths were not the result of their disabilities. The survivors qualify if: 1) An injury or disease incurred or aggravated in the line of duty, while on active duty or inactive duty for training, or the veteran was rated 100% service-connected for ten years or more preceding death, or 2) The veteran was rated 100% service-connected for five years from the date of discharge from military service, or 3) The veteran was a former prisoner of war who was rated as 100% service-connected for at least one year preceding death. The veteran and spouse must have been married for at least one year prior to the veteran’s death, unless they have children together. All DIC payments are subject to judicial offset against any recoveries made under the Federal Torts Claims Act. Non-service-connected survivors’ pension is payable to widows, widowers, or children of veterans whose deaths were not related to their military service and whose estates are incapable of supporting them. The veteran must have served on active duty, under honorable conditions, for at least 90 consecutive active-duty days, with at least one day during a period of war. The improved pension program provides payments to bring an eligible person’s income to a level established by law. These payments are reduced by income from any other source, including Social Security benefits. However, medical expenses may be deducted from the annual income to reduce the individual’s income level. Benefits are not payable to those capable of supporting themselves or those who have assets adequate to provide support. For more information, see http://www.vba.va.gov/survivors

DEPENDENTS’ EDUCATION

Dependents’ Educational Assistance under 38 USC CHAPTER 35 authorizes education and training opportunities to eligible dependents of veterans who are either deceased due to a service-connected condition, or who are rated 100% service-connected permanent and total by VA. The program offers up to 45 months of education benefits, and benefits

may be used for degree and certificate programs, apprenticeships, and on-the-job training. Eligibility rules can be complex. For further information, contact a local accredited veteran service officer, or the Department of Veterans Affairs at 1-888-442-4551, or go to http://www.benefits.va.gov/gibill

A WORD OF CAUTION Accredited service officers focus on helping veterans and dependants in obtaining VA benefits, including aid & attendance benefits, but are not experts on elder law, estate law, federal and state tax law, Medicare, or Medicaid. A veteran, spouse, or family member who is in need of assisted living often is in a situation that overlaps all these areas of law. A decision made in one area can significantly impact the other areas, and there can be severe state and federal tax implications. Therefore, we suggest contacting the National Association of Elder Law Attorneys (http://www.naela.org) for a referral to a local experienced attorney who is well versed in all these areas of law and can provide comprehensive advice to veterans and their families in these types of situations.

IMPORTANT DOCUMENTS The spouse of any veteran eligible for VA benefits should maintain a record of the following documents: 1. The veteran’s original or certified copy of discharge papers, DD214, military and/or separation papers. 2. All marriage, certified divorce decrees and death certificate for the veteran and the spouse (if deceased.) 3. All minor children’s birth certificates. 4. Social Security numbers for the entire family. 5. All medical evaluation boards, disability ratings, or Social Security awards. 6. All hospital and medical records, surgical reports, and treatment records. 7. An official copy of the death certificate. Death certificates can be amended to include serviceconnected conditions, and survivors should try to correct the death certificate if a serviceconnected cause/contributing case is erroneously omitted.

ESTATE ADMINISTRATION INFORMATION INFORMATION CONCERNING INDIVIDUAL: Legal Name: Any Name Variations Used by Veteran: Address: Social Security Number: Citizenship: Date of Birth: Parents:

Birthplace: Mother: Father:

Person to Notify in Case of Emergency: Telephone:

VETERAN’S STATUS: Are You A Veteran?

Yes

No

Branch of Service:

Veteran Service Number:

Rank:

Where Did You Serve and Dates?

MEDALS/COMENDATIONS AWARDED:

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ARE YOU CURRENTLY RECEIVING VETERANS BENEFITS? (List all benefits including disability)

YOUR VETERANS SERVICE OFFICER – (Name, address and telephone number):

MEDICAL INFORMATION: PHYSICIANS:

Primary care:

Phone:

Specialty Care:

Phone:

Specialty Care:

Phone:

Specialty Care:

Phone:

HOSPITAL NAME:

PHONE:

ADDRESS: VA HOSPITALS YOU HAVE BEEN A PATIENT IN:

HEALTH CARE PROVIDER: Telephone:

Provider Number:

EMPLOYMENT: Current Employment Status:

(Choose One)

Occupation:

Name and Address of Employer:

Important Documents fo r Veterans and Their Loved Ones

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IF SELF-EMPLOYED: Name and description of ongoing business:

SHOULD BUSINESS BE: Name, Address and Phone Number to Call for Retirement Benefits, Life Insurance, Etc.:

(Please include your employee ID #)

FINANCIAL PLANNER/OTHER INCOME SOURCES: Name:

Telephone Number:

Other Income Sources: CHURCH AFFILIATION, PASTOR OT SPIRITUAL ADVISER: CHURCH:

Name:

Telephone:

Address:

CLERIC:

Name:

Telephone:

SPIRITUAL ADVISOR: Name:

Telephone:

MARRIAGE HISTORY: SURVIVING SPOUSE:

Name: Address:

Telephone:

Social Security Number:

Date of Birth:

Date of Marriage:

Place of Marriage: DECEASED SPOUSE: Date of Death of Deceased Spouse: (PLEASE INCLUDE A DEATH CERTIFICATE OF YOUR SPOUSE)

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PREVIOUS MARRIAGE:

Name:

Choose one:

(Click Here)

Choose one:

(Click Here)

Date Divorce Became Final: Any Post-Death Obligation to Former Spouse: PREVIOUS MARRIAGE:

Name: Date Divorce Became Final:

Any Post-Death Obligation to Former Spouse: LIVING CHILDREN (NATURAL OR ADOPTED): Name:

Choose One:

(Click Here)

Address: Telephone Number: Date of Birth:

Social Security Number: Place of Birth:

Name:

Choose One:

(Click Here)

Address: Telephone Number: Date of Birth:

Social Security Number: Place of Birth:

Name:

Choose One:

(Click Here)

Address: Telephone Number: Date of Birth:

Social Security Number: Place of Birth:

Name:

Choose One:

(Click Here)

Address: Telephone Number: Date of Birth:

Social Security Number: Place of Birth:

DISABLED AND SPECIAL NEEDS CHILDREN OR DEPENDENTS: Do you have a trust for your dependent with special needs? By creating a “special needs trust” parents or others can provide for a disabled person without risking the loss of government benefits. The key to this kind of trust is that the disabled person is not named as the trustee (manager of the trust) and has no legal control over the assets of the trust.

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Name of Disabled Child or Dependent: Name of Trustee: Date of Birth of Child or Dependent Person:

SS Number:

DECEASED CHILDREN: Name: Date of Birth: Date of Death:

Choose One:

(Click Here)

Place of Birth: Social Security Number:

Cause of Death: Name: Date of Birth: Date of Death:

Choose One:

(Click Here)

Place of Birth: Social Security Number:

Cause of Death: RELATIVES: Name:

Relationship:

Address: Name:

Relationship:

Address: Name:

Relationship:

Address: Name:

Relationship:

Address: Name:

Relationship:

Address: CARE OF PETS: Person to Take Possession: Important Documents fo r Veterans and Their Loved Ones

Phone Number: THE PAPERSAFE

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FUNERAL ARRANGEMENTS: Funeral Home:

Telephone:

Address:

Cemetery:

Plot/Section: Deed Number:

Location:

List all pertinent information which pertains to your funeral arrangements (example: Person to speak at your eulogy. Special requests, music arrangements, Veterans organizations taking part, pallbearers, military honors, etc.)

Person to Notify:

Telephone: Address:

Person to Notify:

Telephone: Address:

Person to Notify:

Telephone: Address:

Person to Notify:

Telephone: Address:

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Person to Notify:

Telephone: Address:

ORGANIZATIONS AND COMMUNITY INVOLVEMENT: Organization:

Telephone:

Member Number:

Member Since:

Positions Held:

Honors/Awards:

Organization:

Telephone:

Member Number:

Member Since:

Positions Held:

Honors/Awards:

Organization:

Telephone:

Member Number:

Member Since:

Positions Held:

Honors/Awards:

Organization:

Telephone:

Member Number:

Member Since:

Positions Held:

Honors/Awards:

WILL/TRUST: Date: Codicil Date:

Location of Original Will: State Where Executed:

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ATTORNEY WHO PREPARED YOUR WILL: Address:

Phone Number: NAMED EXECUTOR/EXECUTRIX: Address:

Phone Number: Relationship to You:

Social Security #:

NAMED CO-EXECUTOR/EXECUTRIX: Address:

Phone Number: Relationship to You:

Social Security #:

SUBSTITUTE OR SUCCESSOR EXECUTOR: Address:

NAMED TRUSTEE: Address:

NAMED TRUSTEE: Address:

SUBSTITUTE OR SUCCESSOR TRUSTEE: Address:

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BENEFICIARY/GUARDIAN: (Determine guardians of minors; corporate status organizations). Name:

Address:

Interest in Estate: BENEFICIARY/GUARDIAN: (Determine guardians of minors; corporate status organizations). Name:

Address:

Interest in Estate:

BENEFICIARY/GUARDIAN: (Determine guardians of minors; corporate status organizations). Name:

Address:

Interest in Estate:

OTHER POSSIBLE BENEFICIARIES: Name:

Relationship:

Address:

Name:

Relationship:

Address:

Name:

Relationship:

Address:

Name:

Relationship:

Address:

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ASSETS PASSING BY WILL, BY LAW, OR BY CONTRACT/DESIGNATION PERSONAL PROPERTY: CASH AMOUNT:____________________ JEWELRY (To be inventoried and appraised):

CLOTHING, FURS, ETC (Inventory and value):

ART OBJECTS (To be inventoried and appraised):

COLLECTIONS (Coins, stamps, etc. to be inventoried and appraised):

FURNITURE / FURNISHINGS (To be inventoried and appraised):

AUTOMOBILE: Year / Make / model: License No.:

Vehicle ID No (VIN):

If not paid in full, who is the lender? Phone number:

Loan number:

Location of title: Registered to: Insured by: Important Documents fo r Veterans and Their Loved Ones

Telephone number: Policy number: THE PAPERSAFE

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AUTOMOBILE: Year / Make / model: License No.:

Vehicle ID No (VIN):

If not paid in full, who is the lender? Phone number:

Loan number:

Location of title: Registered to:

Telephone number:

Insured by:

Policy number:

AUTOMOBILE: Year / Make / model: License No.:

Vehicle ID No (VIN):

If not paid in full, who is the lender? Phone number:

Loan number:

Location of title: Registered to: Insured by:

Telephone number: Policy number:

RECREATIONAL EQUIPMENT (Boat, campers, etc.):

OTHER PERSONAL PROPERTY:

REFUNDS (Income tax, insurance, subscriptions, etc.):

ACCRUED SALARY, VACATION PAY, BONUSES, COMMISSIONS DUE TO YOU:

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REAL ESTATE: PROPERTY ADDRESS:

Location of Abstract: Bank Owning Mortgage: Loan Number: BUSINESS ADDRESS:

Location of Abstract: Bank Owning Mortgage: Loan Number: RENTAL PROPERTY ADDRESS:

Location of Abstract: Bank Owning Mortgage: Loan Number: TIME SHARE ADDRESS:

Location of Abstract: Bank Owning Mortgage: Loan Number: MOBILE HOME:

Make:

Model:

Year:

Address Where Located: Decal #: * Check with your county assessor for information about any lien on this property

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DIRECT DEPOSIT INCOME INFORMATION: Please ensure a responsible party knows your passwords. Bank: Username:

Account #:

Phone #:

Security Code Word (If any):

Which Income? Bank: Username:

Account #:

Phone #:

Security Code Word (If any):

Which Income? Bank: Username:

Account #:

Phone #:

Security Code Word (If any):

Which Income? STOCKS: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered: Name of Corporation:

Number of Shares:

Name(s) in which stock is registered:

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BONDS: Name of Obligor: Face Amount:

Date of Maturity:

Interest Rate/Interest Payable:

Due Date:

Name of Obligor: Face Amount:

Date of Maturity:

Interest Rate/Interest Payable:

Due Date:

Name of Obligor: Face Amount:

Date of Maturity:

Interest Rate/Interest Payable:

Due Date:

Name of Obligor: Face Amount:

Date of Maturity:

Interest Rate/Interest Payable:

Due Date:

U.S. SAVINGS BONDS: U.S. Savings Bonds are no longer issued as paper bonds. If you have already had your paper bonds re-issued to digital, you will have a Treasury Direct account. If you have paper bonds and you have not re-issued them as digital bonds your beneficiary or trustee will have to create a Treasury Direct account to deal with them. The can go to https://www.treasurydirect.gov to set up the necessary accounts, or to login to your current account. My Bonds Are:

Choose One Here ->

Account Password: How Many Bonds?

My Treasury Direct Account #:

Bond Series Number(s) or Letter(s): Total Face Value of All:

LIST PAPER BOND SERIAL #S INDIVIDUALLY IF NEEDED:

Important Documents fo r Veterans and Their Loved Ones

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BROKERAGE ACCOUNTS: Brokerage:

Account Number:

Address: Name(s) on Account:

Acct. Type:

Brokerage:

Choose One -->

Account Number:

Address: Name(s) on Account:

Acct. Type:

Choose One -->

SAFE DEPOSIT BOX: (Please do not put your original will, insurance policies, or this Paper Safe in this box.) Bank:

Telephone Number:

Address: Safe Deposit Box Number:

Where are Keys?

Name(s) box is Registered to, joint tenant or deputy:

LIFE INSURANCE: Company:

Telephone Number:

Address: Policy Number:

Face Value of Policy:

Beneficiary (Individual(s) or Estate/Trust: Company:

Telephone Number:

Address: Policy Number:

Face Value of Policy:

Beneficiary (Individual(s) or Estate/Trust: Important Documents fo r Veterans and Their Loved Ones

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RETIREMENT INCOME: Company:

Telephone:

Address: Account Number:

Account Type:

Company:

Choose One -->

Telephone:

Address: Account Number:

Account Type:

Company:

Choose One -->

Telephone:

Address: Account Number:

Account Type:

Choose One -->

SOCIAL SECURITY BENEFITS & VETERANS BENEFITS: NOTE: The Social Security check received the first week of each month is for the preceding month. Individuals must live the entire month to receive the check, otherwise the check must be returned to the Social Security Administration.

ADDITIONAL INFORMATION NOT LISTED, OR ADDITIONS:

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If you find this gift from the Associates of Vietnam Veterans of America, Inc. to be a useful tool for compiling your personal information, you can request additional copies for your group by using the information provided below. An electronic version of this Paper Safe can also be downloaded and filled in online at www.avva.org/papersafe.html

WE THANK YOU FOR YOUR SERVICE.

Associates of Vietnam Veterans of America 8719 Colesville Road, Suite 100, Silver Spring, MD 20910

For more information on our 501(c)3 organization call 301-585-4000 ext. 169 or visit our website at www.avva.org