Eligibility for Cemetery Interment Request - Louisiana Department of Veterans Affairs

Veteran’s Information
- First Name*
- Last Name*
- Date of Birth:*
  MM slash DD slash YYYY
- Mailing Address*
- Parish/County*
- City*
- Select State*
- Zipcode*
- Email*
- Home Phone*
- Work Phone
- Social Security Number*
- Service Number (if known)
- Branch of Service*
- Date Entered Service*
  MM slash DD slash YYYY
- Date Exited Service*
  MM slash DD slash YYYY
- Type of Discharge*
Spouse Information
- First Name
- Last Name
- Date of Birth:
  MM slash DD slash YYYY
- Social Security Number*
Will the spouse be interred with the veteran?
- Yes
- No
Is the spouse a veteran?
- Yes
- No
Preferences
Military honors at the time of interment is a benefit and an honor earned by the veteran for honorable service in the United States military. Do you wish to have military honors at this funeral?*
- Yes
- No
- N/A
Select a Cemetery for Interment*
Please upload a copy of most recent discharge/separation form DD 214*
Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 40 MB.
Please Note: At the time of burial the family will have a choice of “emblems of belief” and “optional inscription” to be placed on the markers.
Additional paperwork may be required.
An LDVA representative will be in touch if further paperwork is required to complete your application.

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Application for Pre-Need Determination of Eligibility for Interment (Only used prior to death)