A VA Form 29-4125, Claim for One Sum Payment. Download this form, complete it and mail or fax it to us (address and fax # above). You must also send a death certificate (or photocopy) showing date and cause of death of insured.

A VA Form 29-4125, Claim for One Sum Payment. Download this form, complete it and mail or fax it to us (address and fax # above). You must also send death certificates (or photocopies) showing date and cause of death of the insured and of the principal beneficiary or beneficiaries.

VA Form 29-4125, Claim for One Sum Payment. Download this form, complete it and mail or fax it to us (address and fax # above). The claim form must be signed by the executor or administrator of the estate. You must also send a death certificate (or photocopy) showing date and cause of death of the insured. In addition, copies of letters testamentary, letters of administration, or a court order of distribution must be submitted. If these are not available, a statement that there will be no administration of the estate, and VA Form 29-541, Certificate Showing Residence and Heirs of Deceased Veteran, must be filed.

A VA Form 29-4125, Claim for One Sum Payment. Download this form, complete it and mail or fax it to us (address and fax # above). The claim form must be signed by the next of kin, personal representative (guardian, custodian, etc.) or logical person to receive payment for the minor or incompetent. Also, include letters of guardianship, conservatorship, etc. (if any) and address of minor or incompetent. You must also send a death certificate (or photocopy) showing date and cause of death of the insured.