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GENERAL INFORMATION SHEET

CLAIM FOR GOVERNMENT MEDALLION FOR PLACEMENT IN A PRIVATE CEMETERY

RESPONDENT BURDEN – Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. VA cannot conduct or sponsor a collection of information unless it has a valid OMB number. Your obligation to respond is voluntary, however, your response is required to obtain benefits. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the VA Clearance Officer (005R1B), 810 Vermont Avenue, NW, Washington, DC 20420. Please DO NOT send applications for benefits to this address.

BENEFIT PROVIDED – MEDALLION (Only for Veterans who died on or after November 1, 1990)

Furnished upon receipt of claim for affixing to an existing privately-purchased headstone or marker placed at the gravesite of an eligible deceased Veteran who is buried in a private cemetery. The medallion is made of bronze and available in three sizes: Large, Medium, Small. Each medallion is inscribed with the word VETERAN across the top and the Branch of Service at the bottom (see Note in Block 6 of the claim for further information). Eligible Veterans may receive a Government furnished headstone or marker, or a medallion, but not both. If requesting a headstone or marker, please use the VA Form 40-1330.

Shown below are the three medallions with the actual dimensions (+/- 1/32″) for width and height.

DETACH AND RETAIN THIS GENERAL INFORMATION SHEET FOR YOUR RECORDS.

VA FORM JAN 2015

40-1330M

ALL PREVIOUS VERSIONS OF THIS FORM WILL BE OBSOLETE ON OCTOBER 1, 2014

DELIVERY – The medallion is shipped without charge to the name/address designated in Block 13 of the claim. The Government is not responsible for costs associated with affixing the medallion to the privately purchased headstone or marker. Appropriate affixing adhesives, hardware and instructions are provided with the medallion.

Large Medallion Dimensions: 6 3/8″ W, 4 3/4″ H, 1/2″ D

Medium Medallion Dimensions: 3 3/4″ W, 2 7/8″ H, 1/4″ D

Small Medallion Dimensions: 2″ W, 1 1/2″ H, 1/3″ D

WHO IS ELIGIBLE – Any member of the Armed Forces of the United States who dies on active duty and is buried in a private cemetery in a grave marked with a privately purchased headstone or marker. Any deceased Veteran discharged under honorable conditions, who died on or after November 1, 1990, and is buried in a private cemetery in a grave marked with a privately purchased headstone or marker. A deceased Veteran discharged under conditions other than honorable, who died on or after November 1, 1990, and is buried in a private cemetery in a grave marked with a privately purchased headstone or marker, may also be eligible. A copy of the deceased Veteran’s discharge certificate (DD Form 214 or equivalent) or a copy of other official document(s) establishing qualifying military service must be attached. Do not send original documents; they will not be returned. Service after September 7, 1980, must be for a minimum of 24 months continuous active duty or be completed under special circumstances, e.g., death on active duty. Persons who have only limited active duty service for training while in the National Guard or Reserves are not eligible unless there are special circumstances, e.g., death while on active duty, or as a result of training. Reservists and National Guard members who, at time of death, were entitled to retired pay, or would have been entitled, but for being under the age of 60, are eligible; a copy of the Reserve Retirement Eligibility Benefits Letter must accompany the claim. Reservists called to active duty other than training and National Guard members who are Federalized and who serve for the period called are eligible.

WHO CAN APPLY – Federal regulation defines “applicant” as the decedent’s Next of Kin (NOK); a person authorized in writing by the NOK; or a personal representative authorized in writing by the decedent. Written authorization must be included with claim. A notarized statement is not required.

HOW TO SUBMIT A CLAIM

FAX claims and supporting documents to: 1-800-455-7143. IMPORTANT: If faxing more than one claim – fax each claim package (claim plus supporting documents) individually (disconnect the call and redial for each submission).

MAIL claims to: Memorial Programs Service (41B) Department of Veterans Affairs 5109 Russell Road Quantico, VA 22134-3903

A VA medallion may be furnished only upon receipt of a fully completed and signed claim with required supporting documentation.

SIGNATURES REQUIRED – The applicant must sign in Block 12A. The applicant must be the Next of Kin or an authorized representative of the decedent or the Next of Kin.

ASSISTANCE NEEDED – If assistance is needed to complete this claim, you may contact our Applicant Assistance Unit toll free at: 1-800-697-6947, or via e-mail at mps.headstones@va.gov

. No fee should be paid in connection with the preparation of this claim. For more information regarding medallion eligibility, affixing procedures, and sizes, visit our website at www.cem.va.gov

.

CAUTION To avoid delays in the production and delivery of the medallion, please check carefully to be sure you have accurately furnished all required information and documents before faxing or mailing the claim. The Government is not responsible for costs associated with affixing the medallion to the privately purchased headstone or marker. Medallions furnished remain the property of the United States Government and may not be used for any purpose other than to be affixed to the privately purchased headstone or marker of an eligible deceased Veteran buried in a private cemetery.

Form approved, OMB No. 2900-0222 Expiration Date: Feb. 18, 2017 Respondent Burden: 15 minutes

CLAIM FOR GOVERNMENT MEDALLION FOR PLACEMENT IN A PRIVATE CEMETERY

IMPORTANT: Please read the General Information Sheet before completing this claim. Type or print clearly all information except for signatures. Illegible printing could result in incorrect delivery of the medallion. Unless indicated otherwise all other blocks must be completed. MILITARY DISCHARGE DOCUMENTS OR RELATED SERVICE INFORMATION ARE REQUIRED.

1. NAME OF DECEASED VETERAN

FIRST (Or Initial)

MIDDLE (Or Initial)

LAST

SUFFIX

2. GRAVE IS:

CURRENTLY MARKED (with privately purchased marker)

NOT MARKED

VETERAN’S SERVICE AND IDENTIFYING INFORMATION (Use numbers only, e.g., 05-15-1941)

3. VETERAN’S SOCIAL SECURITY NO. OR SERVICE NO.

SSN:

SVC. NO.:

4A. DATE OF BIRTH

MONTH

DAY

YEAR

4B. DATE OF DEATH

MONTH

DAY

YEAR

PERIODS OF ACTIVE MILITARY DUTY

5A. DATE(S) ENTERED

MONTH

DAY

YEAR

5B. DATE(S) SEPARATED

MONTH

DAY

YEAR

6. BRANCH OF SERVICE (BOS) (Check applicable box(es)) NOTE: If one BOS is selected, it will be spelled out on the medallion, i.e. U.S. ARMY, U.S. AIR FORCE, etc. If more than one BOS is selected, they will be abbreviated on the medallion, i.e. USA, USAF, USN, USMC, USCG, etc.

ARMY

MARINE CORPS

COAST GUARD

MERCHANT MARINE

NAVY

AIR FORCE

ARMY AIR FORCES (WW II)

OTHER (USAAC, WAAC, etc.) (Specify)

7. MEDALLION SIZE REQUESTED (Check one) (Refer to instructions for exact sizes)

LARGE (M5)

MEDIUM (M3)

SMALL (M1)

8. NAME AND MAILING ADDRESS OF APPLICANT (No., Street, City, State, and ZIP Code)

9. ARE YOU:

NEXT OF KIN (Specify Relationship)

AUTHORIZED REPRESENTATIVE ON BEHALF OF DECEDENT (Include Written Authorization)

AUTHORIZED REPRESENTATIVE ON BEHALF OF NEXT OF KIN (Include Written Authorization)

10. DAYTIME PHONE NO. OF APPLICANT

11. E-MAIL ADDRESS (Optional)

CERTIFICATION: By signing below I certify the medallion will be affixed to a privately purchased headstone or marker in the cemetery listed in Block 15 at no expense to the Government, and that I (or the party listed in Block 13) have agreed to accept delivery, and all information entered on this claim is true and correct to the best of my knowledge. I also certify, to the best of my knowledge, that the decedent has never committed a serious crime, such as murder or other offense that could have resulted in imprisonment for life, has never been convicted of a serious crime, and has never been convicted of a sexual offense for which he or she was sentenced to a minimum of life imprisonment.

PENALTY: The law provides severe penalties, which include fine or imprisonment, or both, for the willful submission of any statement or evidence of a material fact, knowing it to be false or for the fraudulent acceptance of any benefit to which you are not entitled.

12A. SIGNATURE OF APPLICANT

12B. DATE (MM/DD/YYYY)

13. NAME AND DELIVERY ADDRESS FOR MEDALLION (No., Street, City, State, and ZIP Code); (If same as applicant, please enter SAME)

14. DAYTIME PHONE NO. (Include Area Code)

15. NAME AND ADDRESS OF CEMETERY WHERE PRIVATELY PURCHASED HEADSTONE OR MARKER OF THE DECEASED VETERAN IS LOCATED (No., Street, City, State, and ZIP Code)

VA FORM JAN 2015

40-1330M

ALL PREVIOUS VERSIONS OF THIS FORM WILL BE OBSOLETE ON OCTOBER 1, 2014

 

Quarterly Meeting of the Cape Cod Military, Veteran and Family Collaborative:

Dear Members of the Cape Cod Military, Veteran and Family Collaborative:

Attached please find the agenda for our quarterly meeting on April 6th at the Grace Center in Mashpee.  In response to our commitment to better familiarizing ourselves with veteran services other than our own, Greg Quilty, Barnstable County’s new Veteran Service Officer, will address us on the services his office provides.  

We will also receive updates from our three working committees, and allow time for any announcements in which we may all be interested. At this time, any new thoughts from members would be welcome.

Finally, time will be allotted for small working groups to meet and for members who have not yet chosen a committee to join the conversation.

We hope that as many members as possible will be able to join us and contribute to our future initiatives.  Please let me know if you will be attending and which group you represent, by Friday, March 31.

Thank you as always for your commitment to the Cape Cod Military, Veterans and their Families.

Gina

AMVETS Executive Report

 

 

 

March 2017 AMVETS EXECUTIVE REPORT For AMVETS official Use

990’s

Timeline

Cards

Open accounts

Attachments

  • Refund report
  • NEC Report
  • This report
  • Feb numbers N/A at this time

 

The Tax Man

 

You are running a small business as an AMVETS Post. You must file your 990 every year. Proof of filing your 990 is an IRS response indicating your 990 was accepted. If you fail to file your 990 for 3 consecutive years you appear on the IRS revoked list. You lose your 501c19 status. You then reapply using an IRS 1024 form. We have been working to clean the list and have changed the status of 177 Posts. We see new twists each year. I received a document today showing the IRS fined a Post $2,290 for filing their 990 late. It is attached. Below is a link to the list.

 

IRS AMVETS Revoked

Here is a link to the most current IRS Tax guide. An ounce of prevention is worth a pound of cure.

https://www.irs.gov/pub/irs-pdf/p3386.pdf

 

 

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Timeline-Coming Up

 

 

March NEC (My report is attached)

March final renewal notice email then mail (working on the mail part)

13,889 2016 Annuals still need to renew. 10,887 2015 members owe 2 years (make some calls!)

April– order 70,000 blank annual cards

May-Memorial Day, (plan events and support your posts) Post elections

June-Post Elections (New leaders can’t get in system till reval comes help transition)

July 1 Delegate Strength list for Convention

July 15-Pull all current annual members list for cards send to printer (mailed to Depts.)

July-15 Revalidations Due (if you hold revals till the last day it jams the system, send em as you get them)

August 1 apply renewal invoices (reval dues info applied, standard dues would allow earlier invoicing)

August 1-Cards hit Depts. and are sent to Posts

August 7 Invoices to printer for mailing (dues renewal contacts)

August 15 Invoices arrive at members

August 31 End of Membership Year

Sept 1 Members Pay and are given Cards

 

Love it when a plan comes together.

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New Annual Member Cards

How do “new annual members” receive the hard plastic membership cards? Here’s how it works, at the end of each month I query the database for new members. I will select the March new members on 1 April and send the list to a vendor that prints the name and expiration date on the card and then sends the card and a welcome letter to the new member. It usually takes a week to get everything prepared and sent. The card should be to the member by the 15th of the next month April in this example. If someone joins on 1 March the longest it would take is 45 days to get the card. If someone joins on 30 March they get their card in 2 weeks max. We send the cards to MALs and new post joins.  If a member joins online as an MAL they get an email with a temporary card. If they join through a post they get the temporary card from the join form or the tear off from our brochure. The big difference is, in the past they would keep the temporary card for a year till they renewed. One of the benefits of receiving a card and a letter within the first month is, it is a form of member engagement. We need to communicate as often as we can with our members; it generates a feeling of belonging and helps us with member retention.

 

 

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How does a life member get a card? When a life member join AMVETS s “online” his name appears on a morning report and the new card and life package is sent out by the following day.

The 1st is the fastest: A veteran joins as a life member through our join button on the website. We see his name the next day and mail him his Life package which includes a Life Card. He is a non-voting member at large.

The 2nd “online” method is if a veteran gives a $250 check to the Post. The Post deposits the check then enters the data online and pays with post credit card. It can happen within a day or two depending on the Post 1st Vices workload.

The 3rd “online” entry is by the Department. Some posts deposit the check then write a second check and send the second check with a Life Membership Transmittal form to the Department. This can lengthen the time it takes for the member to get his card by 2 or three weeks. It depends on the post and the mail. Once it reaches the Dept it can also go in an inbox until the Dept can enter the data.

How can I get a new card if mine is lost? All members can login and go to my shopping cart and order new cards. Plastic life and Plastic annual cards are both $5. Please destroy any old forms you have at the Post that says life cards are $2. Occasionally we get a check sent to HQ for $2. We run a list every morning of members ordering cards online. We print the cards at HQ and send them daily.

Does your Dept have open Accounts?

Here is how you can check. Open your Dept Roster (or post) and sort the K column (expiration dates ) from least to greatest. Then scroll dowm you will see 8/31/2015 at the top then scroll through your life members. At the end of the life expiration dates 12/31/2078 you may see members without expiration dates (k column is blank). These are members that were entered in the datatbase but were never paid for. These are open accounts. Please work with membership to close these accounts. The system captures the membership number of the leader that entered these veterans.  Look hard at the veterans that paid for Life memberships. Please work with membership to close these accounts prior to 1 July when the delegate strenght list pulled.If you need help sorting your roster call my staff at 301-683-4021

Section 5. No delegate of an accredited post or department shall be seated at the national

convention unless the respective post and department shall be fully paid up in all its

accounts with National Headquarters and national districts and their accounts and

membership shall be certified as of 30 days prior to the opening date of the national

convention.

 

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Do you have a job opening at your Department, Post or your veteran owned business?  Send it to our Career Centers. We have veterans across the country looking for work. If you know a vet looking for work get them in touch with our center!

Ciera Robinson, AMVETS Career Center crobinson@amvets.org  Desk: 301.683.4029  

Thanks for volunteering your time to help veterans, you built AMVETS!

 

 

Harry Neal

AMVETS National Membership Director

301-683-4020

US Army Infantry

 

 

 

Thanks To Yanks March 2017 E-Newsletter

March 2017 E-Newsletter View this email in your browser Save the date Third Annual All You Can Eat Fundraiser April 9, 2017 8am to noon All proceeds raised will benefit Thanks To Yanks’ mission of supporting our military, veterans and their families.  $8 per person/$5 per child Help support Thanks To Yanks with Amazon When you […]