Application Flag Burial Form – Fill Out and Use This PDF

1. FIRST, MIDDLE, LAST NAME OF VETERAN (Print or type)

2. OTHER NAMES USED BY VETERAN (Print or type)

3. VA FILE NUMBER

4. SOCIAL SECURITY NUMBER

5. MILITARY SERVICE NUMBER/SERIAL NUMBER

ARMY

NAVY

AIR FORCE

MARINE CORPS

COAST GUARD

SELECTED SERVICE

OTHER (Specify)

7.DATE ENTERED ACTIVE DUTY (or Selected Reserve)

8.DATE RELEASED FROM ACTIVE DUTY (or Selected Reserve)

9. DATE OF BIRTH

10. DATE OF DEATH

11. DATE OF BURIAL

12.PLACE OF BURIAL (Name of cemetery, city, and State)

YES

14A. NAME OF PERSON ENTITLED TO RECEIVE FLAG

14B. ADDRESS OF PERSON ENTITLED TO RECEIVE FLAG (Number and street or rural route, city or P.O., State and ZIP Code)

16. SIGNATURE OF APPLICANT (Sign in INK)

SIGNATURE OF PERSON RECEIVING FLAG (Sign in INK)

NAME AND ADDRESS OF POST OFFICE OR OTHER FLAG ISSUE POINT

DATE FLAG RECEIVED

FOR VA USE

DATE FLAG ISSUED

SIGNATURE OF POSTMASTER OR OTHER ISSUING OFFICIAL

ADDRESS OF POST OFFICE OR OTHER FLAG ISSUE POINT

FOR VA USE

DATE OF REPLACEMENT

A. How can I contact VA if I have questions?

If you have questions about this form, how to fill it out, or about benefits, contact your nearest VA regional office. You can locate the address of the nearest regional office in your telephone book blue pages under "United States Government, Veterans" or call 1-800-827-1000 (Hearing Impaired TDD line 1-800-829-4833). You may also contact VA by Internet at https://iris.va.gov/.

B. How do I apply for a burial flag?

Complete VA Form 21-2008, and submit it to a funeral director or a representative of the veteran or other organization having charge of the funeral arrangements or acting in the interest of the veteran. You may get a flag at any VA regional office or U.S. Post Office. When burial is in a national, State or military post cemetery, a burial flag will be provided.

C. Who is eligible for a burial flag?

Generally, veterans with an other than dishonorable discharge NOTE: This includes veterans who served in the Philippine military forces while such forces were in the service of the U.S. armed forces under the President's Order of July 26, 1941 and died on or after April 25, 1951, and veterans who served in the Philippine military services and are eligible for burial in a national cemetery

Veterans who were entitled to retired pay for service in the reserves, or would have been entitled to such pay but not for being under 60 years of age

Members or former members of the Selected Reserve (Army, Air Force, Coast Guard, Marine Corps, or Naval Reserve; Air National Guard; or Army National Guard) who served at least one enlistment or, in the case of an officer, the period of initial obligation, or were discharged for disability incurred or aggravated in line of duty, or died while a member of the Selected Reserve

D. Who is not eligible for a burial flag?

Veterans who received a dishonorable discharge

Members of the Selected Reserve whose last discharge from service was under conditions less favorable than honorable

Peacetime veterans who were discharged before June 27, 1950 and did not serve at least one complete enlistment or incur or aggravate a disability in the line of duty

Veterans who were convicted of a Federal capital crime and sentenced to death or life imprisonment, or were convicted of a State capital crime and sentenced to death or life imprisonment without parole, or were found to have committed a Federal or State capital crime but were not convicted by reason of not being available for trial due to death or flight to avoid prosecution

Discharged or rejected draftees, or members of the National Guard, who reported to camp in answer to the President's call for World War I service but who, when medically examined, were not finally accepted for military service

D. Who is not eligible for a burial flag? (CONTINUED) Persons who were discharged from World War I service prior to November 12, 1918, on their own application or solicitation by reason of being an alien, or any veterans discharged for alienage during a period of hostilities

Persons who served with any of the forces allied with the United States in any war, even though United States citizens, if they did not serve with the United States armed forces

Persons inducted for training and service who, before entering such training and service were transferred to the Enlisted Reserve Corps and given a furlough

Former temporary members of the United States Coast Guard Reserve

E. What documentation is required in order to receive a burial flag?

Provide a copy of the veteran's discharge documents that shows service dates and the character of service, such as DD Form 214, or verification of service from the veteran's service department or VA. Note: If the claimant is unable to provide documentary proof, a flag may be issued when a statement is made by a person of established character and reputation that he/she personally knows the deceased to have been a veteran who meets the eligibility criteria.

F. Who is eligible to receive a burial flag?

Only one flag may be issued for each deceased veteran. Generally, the flag is given to the next-of-kin as a keepsake after its use during the funeral service. The flag is given to the following person(s) in the order of precedence listed:

surviving spouse

children, according to age

parents, including adoptive, stepparents, and foster parents

brothers or sisters, including brothers or sisters of half blood

uncles or aunts

nephews or nieces

others, such as cousins or grandparents

When there is no next-of-kin, VA will furnish the flag to a friend making a request for it. If there is no living relative or one cannot be located, and no friend requests the flag, it must be returned to the nearest VA facility.

NOTE: The flag cannot be replaced if it is lost, destroyed, or stolen. Additionally, a flag may not be issued after burial unless it was impossible to obtain a flag in time to drape the casket or accompany the urn before burial. If the next-of-kin or friend is requesting the flag after the veteran's burial, he or she must personally sign the application and explain in Item 15 "Remarks" the reason that prevented timely application for a burial flag.

1.This flag is issued on behalf of the Department of Veterans Affairs to honor the memory of one who has served our country.

2.When used to drape the casket, the flag should be placed as follows:

(a) Closed Casket - When the flag is used to drape a closed casket, it should be so placed that the union (blue field) is at the head and over the left shoulder of the deceased.

(b)Half Couch (Open) - When the flag is used to drape a half-couch casket, it should be placed in three layers to cover the closed half of the casket in such a manner that the blue field will be the top fold, next to the open portion of the casket on the deceased's left.

(c)Full Couch (Open) - When the flag is used to drape a full-couch casket, it should be folded in a triangular shape and placed in the center part of the head panel of the casket cap, just above the left shoulder of the deceased.

3.During a military commitment ceremony, the flag which was used to drape the casket is held waist high over the grave by the pallbearers and, immediately after the sounding of "Taps," is folded in accordance with the illustration below.

4.Folding the flag (see illustration below):

5.The flag should not be lowered into the grave or allowed to touch the ground. When taken from the casket, it should be folded as shown (see illustration).

6.The flag should form a distinctive feature of the ceremony of the unveiling of a statue or monument, but it should never be used as a covering for the statue or monument.

7.The flag should never be fastened, displayed, used, or stowed in such a manner as will permit it to be easily torn, soiled, or damaged in any way.

8.The flag should never have placed upon it, nor any part of it, nor attached to it, any mark, insignia, letter, word, figure, design, picture, or drawing of any nature.

9.The flag should never be used as a receptacle for receiving, holding, carrying, or delivering anything.

10.The flag, when badly worn, torn, or soiled should no longer be publicly displayed, but privately destroyed by burning in such a manner as to convey no suggestion of disrespect or irreverence.

(A)Straighten out the flag to full length and fold lengthwise once, folding the lower striped section of the flag over the blue field.

(B)Fold the flag lengthwise a second time to meet the open edge, making sure that the union of stars on the blue field remains outward in full view.

(C)A triangular fold is then started by bringing the striped corner of the folded edge to the open edge.

(D)The outer point is then turned inward, parallel with the open edge to form a second triangle.

(E)The diagonal or triangular folding is continued toward the blue union until the end is reached, with only the blue showing and the form being that of a cocked (three corner) hat.