DD Form 1375 at a glance
What it is: DD FORM 1375 is the request for payment of funeral and/or interment expenses, which records the amount of funeral and/or interment expenses incurred by next of kin.
Who signs: The claimant signs under SIGNATURE OF CLAIMANT.
Part II is to be completed by the claimant (proper completion will expedite settlement).
A filled-in DD Form 1375 example: a daughter claims the funeral costs
How to fill out DD Form 1375, box by box
Military activity preparing this form and mailed to for payment
Part I is to be completed by military authorities: under 1. MILITARY ACTIVITY PREPARING THIS FORM and under 2. MILITARY ACTIVITY FORM IS TO BE MAILED TO FOR PAYMENT, enter the NAME and the ADDRESS (Street, City, State and ZIP Code).
Decedent, claimant and funeral home
Enter the NAME OF DECEDENT (Last, First, Middle Initial) in 3, the PAY GRADE/RANK in 4 and the DCIPS CASE NUMBER in 5.
Enter the PLACE OF DEATH (City, State, Country) in 6 and the DATE OF DEATH (YYYYMMDD) in 7.
Enter the NAME OF CLAIMANT (Last, First, Middle Initial) in 8 and the RELATIONSHIP in 9.
Under 10. FUNERAL HOME AND/OR NATIONAL CEMETERY, enter the NAME and the ADDRESS (Street, City, State and ZIP Code).
Government contract for care of remains
For 11. GOVERNMENT CONTRACT FOR CARE OF REMAINS IN EFFECT AT PLACE OF DEATH, mark NO or YES; for YES, enter name of contracting activity.
Cemetery and date of interment
Complete Items 12 and 13. Complete either Item 14, 15, or 16 (do not complete more than one).
Under 12. CEMETERY, MAUSOLEUM OR OTHER DISPOSITION, enter the NAME and the ADDRESS (Street, City, State and ZIP Code), and enter the DATE OF INTERMENT (YYYYMMDD) in 13.
Interment costs
14. INTERMENT COSTS is to be completed when the claimant arranged for interment only. Enter total amount paid or incurred for one or more of the following: cost of single grave site; opening and closing grave; burial vault; church service or clergy's fee; obituary notice; flowers; services of funeral director; and motor service.
Funeral arrangement
15. FUNERAL ARRANGEMENT is to be completed when the claimant made all arrangements. Enter total amount paid or incurred for one or more of the following: casket; preservation (embalming) and related services; cremation and urn; clothing for deceased; cost for interment; and shipment of remains.
Shipping costs of remains
16. SHIPPING COSTS OF REMAINS is to be completed when the claimant paid or incurred cost for shipment of remains. Enter total amount paid or incurred for one or more of the following: removal from place of death to preparation point, delivery from preparation point to common carrier, shipping costs, removal from common carrier to receiving funeral home, and delivery to cemetery.
17. SHIPMENT OF REMAINS is to be completed when shipping costs claimed: enter SHIPPED FROM (City and State), SHIPPED TO (City and State) and MODE OF SHIPMENT (X one), AIR or HEARSE.
Statement of the claimant
18. STATEMENT OF CLAIMANT: I have paid or incurred expenses in the amounts entered in Items 14, 15, and/or 16. I desire that the amount allowable by the Government be paid to: enter the NAME OF PAYEE (Print or type), the TAXPAYER ID NUMBER OR SSN and the ADDRESS OF PAYEE (Street, City, State and ZIP Code), the SIGNATURE OF CLAIMANT and the DATE SIGNED.
Complete Item 17, when cost of shipment of remains is claimed in Item 15 or as Item 16. Attach copies of bills for all amounts claimed. Mail completed form to addressee shown in Item 2.
More rules for DD Form 1375
Disclosure is voluntary, but failure to provide requested information may result in claim not being paid.
Sources
[1] DD Form 1375 (NOV 2019), Request for Payment of Funeral and/or Interment Expenses, Department of Defense (the Official source link on this page).