NCA Emerging Burial Needs Survey

NCA Emerging Burial Needs Survey

NCA_SURVEY_Jan 16 [Booklet]

NCA Emerging Burial Needs Survey

OMB: 2900-0792

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VETERANS BURIAL BENEFITS SURVEY

SECTION 5

26) Are you aware of any memorialization methods you

In addition to headstones, markers, and the Presidential
Certificate that NCA currently provides Veterans, there
may be additional methods to memorialize a Veteran’s
life and service to the country. Through recent advances
in technology, the following information could be
provided on a website and/or through handheld devices
so that loved ones, and other people they choose, have
access to it.
23) Specific information about your burial location, such as

directions to the gravesite and a picture of the headstone.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

24) Information about your military service, such as where

you enlisted, the rank you achieved, the places you were
stationed, and your military specialty and decorations.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT
DISAGREE
STRONGLY
DISAGREE
STRONGLY DISAGREE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

25) Information about your life after the military and

your family.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
STRONGLY
SOMEWHAT
DISAGREE
DISAGREE
STRONGLY DISAGREE

PAGE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

5

VETERANS BURIAL BENEFITS SURVEY

2012

and your loved ones might consider that are not
mentioned above?
Please write your answer.

30) What is your sex?
1 Male
2 Female
31) In what year were you born?
32) Are you Spanish, Hispanic, or Latino?

SECTION 6
Next, we would like to understand your background.
This information will not be used to identify you, but will
only be used to analyze survey responses.
27) In which branch of Service did you serve?
Please mark all that apply.
1 Air Force
2 Air Force Reserve
3 Air National Guard
4 Army
5 Army National Guard
6 Army Reserve
7 Coast Guard
8 Coast Guard Reserve
9 Marine Corps
10 Marine Corps Reserve
11 Navy
12 Navy Reserve

1

Yes

2

No

33) Which of the following best describes your race?
Please mark all that apply.
1 American Indian or Alaskan Native
2 Asian
3 Black or African American
4 Native Hawaiian or Other Pacific Islander
5 White

29) What was your pay grade at the time of your last
separation/retirement?
1 E1-E4
2 E5-E6
3 E7-E9
4 WO1-CW5
5 O1-O3
6 O4-O6
7 O7-O10

Continue to next page 

38) Are you currently receiving any of the following
benefits from the VA?
Please mark all that apply.
1 Eligibility for VA health care
2 VA health care facility locations
3 VA life insurance
4 VA home loans
5 VA education and training
6 VA vocational rehabilitation
7 VA burial and memorial benefits
8 VA disability compensation and pension
9 VA benefits for dependents and survivors
10 VA transition assistance
11 VA prescription benefits
12 Other:

Veterans Burial Benefits
SU RVE Y 2012

Purpose of Survey The Department of Veterans Affairs (VA) is conducting this survey to improve the quality of our current burial benefits program and guide its direction in the future. The information we collect will be used to help serve you
better, and you will learn about your burial benefits as you complete the survey.
You may also take this survey online by entering the following URL in your web browser: www.?????@?????.com.
Enter the following access code when prompted on the introduction screen: ??????.
Along with taking our survey, you can also help us by participating in a focus group or personal interview. If you would like
to participate in such an activity in your area, please provide us with your phone number and/or email address at the end
of the survey so that we can set up a time that is convenient for you.

34) What is the highest education or degree you
have received?
1

2
3
4
5

High school diploma/GED or other high
school equivalency
Some college credit, but no degree
Associate’s degree (e.g., A.A., A.S.)
Bachelor’s degree (e.g., B.A., B.S.)
Graduate or professional degree
(e.g., M.A., Ph.D., M.D., J.D.)

Thank you again for sharing your perspective. It will be
very helpful as we work to identify ways to honor our
Veterans; feedback from you and other Veterans will be
a big part of making improvements to the VA’s service
offerings. If you would like additional information,
please visit www.cem.va.gov

35) What was your total family income for 2011 before
taxes and deductions (gross income)?
1

28) When did you begin your first term of service?
1 September 2001 or later
2 August 1990 to August 2001 (includes Persian Gulf War)
3 May 1975 to July 1990
4 Vietnam Era (1964-1975)
5 February 1955 to July 1964
6 Korean War (July 1950 to January 1953)
7 January 1947 to June 1950
8 World War II (December 1941 to December 1945)
9 November 1941 or earlier

2012

2
3
4
5
6
7
8

Less than $10,000
$10,001 - $20,000
$20,001 - $30,000
$30,001 - $40,000
$40,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
More than $100,000

36) What is your current marital status?
1 Married, living with spouse
2 Married, not living with spouse
3 Widowed
4 Divorced
5 Legally separated
6 Never married
37) What is your religious affiliation?
Please mark only one.
1 Protestant
2 Catholic
3 Jewish
4 Muslim
5 Other religion (Please be specific)
6 No religion

PAGE

6

Along with this survey, we are conducting a series of interviews
and focus groups with Veterans to better understand their needs
regarding this important part of their lives. The topics covered in
these activities will be the same as those explored in this survey.
If you would like to participate in such an activity in your area,
please provide us your phone number and/or email address so
that we may set up a time that is convenient for you. Your
contact information will NOT be used for any other purpose than
to make these arrangements and, along with this survey, will be
destroyed at the conclusion of this project.
TELEPHONE NUMBER:

EMAIL:

Your Burial Benefits

Risk to Participants

As a Veteran, you may be eligible to be buried in a national
or state Veterans’ cemetery. Burial benefits include a gravesite in one of
the 131 national Veteran’s cemeteries or one of the
81 state Veterans’ cemeteries, opening and closing of the grave, perpetual
maintenance of the gravesite, a government-provided headstone or
marker, a U.S. flag, and a Presidential Memorial Certificate. These
benefits are available at no cost to the family and apply to both casketed
and cremated remains.

There is no measurable risk to participants associated with
completing the survey. Participation will in no way impact
your Veterans’ benefits.

Your spouse and/or dependents may also be eligible to be interred with
you in a shared gravesite at a national/state Veterans’ cemetery. This
benefit includes burial with the Veteran, perpetual maintenance of the
gravesite, and their names and dates of birth and death inscribed on the
Veteran’s headstone, at no cost to the family.

VA may not conduct, sponsor, or require the respondent to
respond to this collection of information unless it displays a
valid OMB Control Number. All responses to this collection
are voluntary. Public reporting burden for this collection of
information is estimated to average 15 minutes per response,
including the time necessary for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.
Failure to furnish the requested information will have no adverse
effect on any VA benefits to which you may be entitled.

Some Veterans may also be eligible for a Burial Allowance, a partial
reimbursement of an eligible Veteran’s burial and funeral costs. When
the cause of death is not service-related, the reimbursement generally
consists of two parts: (1) a burial and funeral expense allowance, and (2)
a plot or interment allowance. There are no benefits available to spouses
and dependents buried in a private cemetery. For more information on
your benefits, please visit the NCA website: www.cem.va.gov.
Use of Survey Results
The Department of Veterans Affairs will be using the information
collected from you to improve services and plan for the future needs of
Veterans and their families. Your responses will not impact your benefits
in any way.
Confidentiality of Data
All survey responses are kept strictly confidential and will only
be used to report group-level findings. Completion of this
survey is voluntary; if you complete the survey, you may skip
any question you do not wish to answer.

OMB Statement
OMB Control Number: To be determined
Public Reporting Burden Statement

Respondents are assured that answers given will be kept
confidential under the Privacy Act and will be used for research
purposes only. The information that respondents supply is
protected by law (the Privacy Act of 1974, 5 U.S.C. 522a and
section 5701 of the Title 38 of the United States Code). Disclosure
of information involves releases of statistical data
and other non-identifying data for the improvement of services
and associated administrative purposes. If you have comments
regarding this burden estimate or any aspects of this collection of
information, please call 1-866-216-0695 for mailing information
on where to send your comments.
Thank you for taking the time to complete this survey and for
helping improve the VA’s Burial Benefits Program. Continue>

VETERANS BURIAL BENEFITS SURVEY

SECTION 1
Please remember this survey is voluntary and
confidential. Your responses will be combined
with others and will not affect your benefits in
any way. Thank you for your participation.
1) Have you given much thought to planning your burial?
1 Thought about it a lot
2 Thought about it some
3 Thought about it hardly at all
4 Never thought about it
2) Before receiving this survey, how aware were you
of your burial benefits offered by the VA?
1 Very aware
2 Somewhat aware
3 Unaware
3) Have you done any of the following?
Please mark all that apply.
1
2
3

Visited a national cemetery
Attended a funeral ceremony at a national cemetery
Planned or helped to plan a funeral ceremony
for a Veteran

4) Have you discussed your burial preferences with your
spouse or other family members?
1 Yes
2 No
5) When thinking about the arrangements for your
funeral, what are your three most important
concerns?
1 My religious beliefs
2 My family’s or loved ones’ religious beliefs
3 My culture/heritage
4 My family’s or loved ones’ culture/heritage
5 Cost
6 That the ceremony be dignified
7 That the burial is familiar and/or traditional
8 Environmental impact
6) When choosing the location of your burial, what are

your two most important concerns?
1 It is near my residence
2 My remains will be near other deceased family
members or loved ones
3 It is located near other fallen service men and women
4 Family and friends are able to visit
5 Cost
6 Other:

PAGE

2

2012

7) How likely are you to choose burial in a national Veterans'
cemetery?
1 Very likely
2 Somewhat likely
3 Neither likely nor unlikely
4 Very unlikely
5 Definitely would not

VETERANS BURIAL BENEFITS SURVEY

11) Some people choose to be buried at sea, in which
their cremated or casketed remains are committed
to the ocean.
STRONGLY AGREE

1

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

9) The following burial options are currently offered by the VA.
If you had to choose one of these options today, which
option do you think you would choose?
1 In-ground casket burial
2 Cremation, in-ground burial
3 Cremation, columbarium (a vault for cremation remains)
4 Don’t know

C. The VA/NCA should offer this
method to Veterans.

1

2

2

2

3

3

3

STRONGLY AGREE

4

4

4

5

5

5

12) Some people choose to have their cremated
remains scattered in the air from a balloon or other
types of aircraft.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

SECTION 2

SOMEWHAT DISAGREE
STRONGLY DISAGREE

The next section asks you about burial methods
that are not currently offered by the VA. We are
interested in your opinions of these methods for yourself
and for other Veterans. For each of the following
statements, please indicate your agreement
or disagreement.
10) Some people choose to have their remains placed in
mausoleums, which are small buildings with walls, a roof
and sometimes a door. Mausoleums are used for storing
the remains of one or more people, either wholly above
ground or within a burial vault below the structure.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

4

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

3

4

5

SOMEWHAT DISAGREE
STRONGLY DISAGREE

STRONGLY AGREE

A. I would choose this method for
myself.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

D. This is method would uphold the
dignity and sanctity of the national
cemeteries.

1

2

3

4

5

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

15) Some cemeteries create dedicated sections that are
intended to lower the impact on the environment by
using only biodegradable caskets, as well as
biodegradable pesticides, natural fertilizers, and organic
gardening techniques. These sections may also have
some limitations on the use of concrete grave vaults,
site decoration, and memorial markers.

13) Some people choose embalming methods that utilize
only biodegradable materials, or they choose to have
their remains buried without embalming. If not
embalmed, remains are held in cooled facilities and/or
interred in a timely fashion.

A. I would choose this method
for myself.

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer
this method to Veterans.

1

2

3

4

5

D. This method would uphold
the dignity and sanctity of
the national cemeteries.

1

2

3

4

5

PAGE

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

D. This method would uphold the dignity
and sanctity of the national
cemeteries.

1

2

3

4

5

3

2

3

4

5

B. This kind of cemetery would be
a respectful and dignified way to
treat Veterans’ remains.

1

2

3

4

5

C. The VA/NCA should offer this kind
of cemetery to Veterans.

1

2

3

4

5

D. This kind of cemetery would
uphold the dignity and sanctity
of the national cemeteries.

1

2

3

4

5

SECTION 4
Next, we’d like you to think about ceremonies that
people perform at burials, including traditional rituals
related to their religion or cultural or ethnic background.
19) Are there any ceremonies, perhaps related to your cultural

heritage or religious or ethnic background, that you would
like to have at your burial?
Please write your answer.

20) Would the ceremony you wrote above include any of the
following at the gravesite?
Please mark all that apply.
1
2
3
4

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

Food
Flowers
Music
Leaving gifts or mementos

21) Would you still choose to be buried at a national Veterans'
cemetery if the kind of ceremony you wanted was
not allowed?
Please mark all that apply.
1 Yes
2 No
3 Not applicable, I do not want a ceremony.
4 Not applicable, I believe they allow the ceremony I want.
22) Why or why not?

Please write your answer.

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

18) Are you aware of any other burial methods you and your

loved ones might consider that are not mentioned above?
Please write your answer.

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

1

cremated remains are used to create a new coral reef
habitat. In this process, cremated remains are incorporated
with cement to create a structure that is placed on the
sea floor in a designated reef reclamation area. The
structure may include a memorial plaque, and mourners
may visit the site by boat or by snorkeling or scuba diving.

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

5

A. I would choose this kind
of cemetery for myself.

17) Some people choose coral reef burials, in which their

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

1

2012

SOMEWHAT DISAGREE
STRONGLY DISAGREE

SOMEWHAT DISAGREE
STRONGLY DISAGREE

Some people choose methods of treating remains that
are intended to lower the impact on the environment.
The following questions refer to these types of practices.

A. I would choose this method for
myself.

3

2

SECTION 3

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE

2

A. I would choose this method for
myself.

1

2

natural appearance. These cemeteries might contain
only plants and materials native to the region. Memorial
markers might be restricted to trees or naturally
occurring rocks to maintain the natural appearance.
Some areas of these cemeteries may also restrict visitor
access, similar to natural conservation areas, while other
areas may actively encourage visitors, similar to parks.

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

16) Some cemeteries are designed and maintained to have a

14) Some people choose to use a biodegradable casket or a
simple cloth shroud to wrap the body for burial rather
than a traditional casket to reduce the impact on the
environment.

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

8) Have you ever considered any types of burial options
other than a casketed burial or cremation?
1 Yes
2 No

VETERANS BURIAL BENEFITS SURVEY

2012

PAGE

4

Continue to next page 

VETERANS BURIAL BENEFITS SURVEY

SECTION 1
Please remember this survey is voluntary and
confidential. Your responses will be combined
with others and will not affect your benefits in
any way. Thank you for your participation.
1) Have you given much thought to planning your burial?
1 Thought about it a lot
2 Thought about it some
3 Thought about it hardly at all
4 Never thought about it
2) Before receiving this survey, how aware were you
of your burial benefits offered by the VA?
1 Very aware
2 Somewhat aware
3 Unaware
3) Have you done any of the following?
Please mark all that apply.
1
2
3

Visited a national cemetery
Attended a funeral ceremony at a national cemetery
Planned or helped to plan a funeral ceremony
for a Veteran

4) Have you discussed your burial preferences with your
spouse or other family members?
1 Yes
2 No
5) When thinking about the arrangements for your
funeral, what are your three most important
concerns?
1 My religious beliefs
2 My family’s or loved ones’ religious beliefs
3 My culture/heritage
4 My family’s or loved ones’ culture/heritage
5 Cost
6 That the ceremony be dignified
7 That the burial is familiar and/or traditional
8 Environmental impact
6) When choosing the location of your burial, what are

your two most important concerns?
1 It is near my residence
2 My remains will be near other deceased family
members or loved ones
3 It is located near other fallen service men and women
4 Family and friends are able to visit
5 Cost
6 Other:

PAGE

2

2012

7) How likely are you to choose burial in a national Veterans'
cemetery?
1 Very likely
2 Somewhat likely
3 Neither likely nor unlikely
4 Very unlikely
5 Definitely would not

VETERANS BURIAL BENEFITS SURVEY

11) Some people choose to be buried at sea, in which
their cremated or casketed remains are committed
to the ocean.
STRONGLY AGREE

1

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

9) The following burial options are currently offered by the VA.
If you had to choose one of these options today, which
option do you think you would choose?
1 In-ground casket burial
2 Cremation, in-ground burial
3 Cremation, columbarium (a vault for cremation remains)
4 Don’t know

C. The VA/NCA should offer this
method to Veterans.

1

2

2

2

3

3

3

STRONGLY AGREE

4

4

4

5

5

5

12) Some people choose to have their cremated
remains scattered in the air from a balloon or other
types of aircraft.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

SECTION 2

SOMEWHAT DISAGREE
STRONGLY DISAGREE

The next section asks you about burial methods
that are not currently offered by the VA. We are
interested in your opinions of these methods for yourself
and for other Veterans. For each of the following
statements, please indicate your agreement
or disagreement.
10) Some people choose to have their remains placed in
mausoleums, which are small buildings with walls, a roof
and sometimes a door. Mausoleums are used for storing
the remains of one or more people, either wholly above
ground or within a burial vault below the structure.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

4

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

3

4

5

SOMEWHAT DISAGREE
STRONGLY DISAGREE

STRONGLY AGREE

A. I would choose this method for
myself.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

D. This is method would uphold the
dignity and sanctity of the national
cemeteries.

1

2

3

4

5

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

15) Some cemeteries create dedicated sections that are
intended to lower the impact on the environment by
using only biodegradable caskets, as well as
biodegradable pesticides, natural fertilizers, and organic
gardening techniques. These sections may also have
some limitations on the use of concrete grave vaults,
site decoration, and memorial markers.

13) Some people choose embalming methods that utilize
only biodegradable materials, or they choose to have
their remains buried without embalming. If not
embalmed, remains are held in cooled facilities and/or
interred in a timely fashion.

A. I would choose this method
for myself.

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer
this method to Veterans.

1

2

3

4

5

D. This method would uphold
the dignity and sanctity of
the national cemeteries.

1

2

3

4

5

PAGE

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

D. This method would uphold the dignity
and sanctity of the national
cemeteries.

1

2

3

4

5

3

2

3

4

5

B. This kind of cemetery would be
a respectful and dignified way to
treat Veterans’ remains.

1

2

3

4

5

C. The VA/NCA should offer this kind
of cemetery to Veterans.

1

2

3

4

5

D. This kind of cemetery would
uphold the dignity and sanctity
of the national cemeteries.

1

2

3

4

5

SECTION 4
Next, we’d like you to think about ceremonies that
people perform at burials, including traditional rituals
related to their religion or cultural or ethnic background.
19) Are there any ceremonies, perhaps related to your cultural

heritage or religious or ethnic background, that you would
like to have at your burial?
Please write your answer.

20) Would the ceremony you wrote above include any of the
following at the gravesite?
Please mark all that apply.
1
2
3
4

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

Food
Flowers
Music
Leaving gifts or mementos

21) Would you still choose to be buried at a national Veterans'
cemetery if the kind of ceremony you wanted was
not allowed?
Please mark all that apply.
1 Yes
2 No
3 Not applicable, I do not want a ceremony.
4 Not applicable, I believe they allow the ceremony I want.
22) Why or why not?

Please write your answer.

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

18) Are you aware of any other burial methods you and your

loved ones might consider that are not mentioned above?
Please write your answer.

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

1

cremated remains are used to create a new coral reef
habitat. In this process, cremated remains are incorporated
with cement to create a structure that is placed on the
sea floor in a designated reef reclamation area. The
structure may include a memorial plaque, and mourners
may visit the site by boat or by snorkeling or scuba diving.

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

5

A. I would choose this kind
of cemetery for myself.

17) Some people choose coral reef burials, in which their

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

1

2012

SOMEWHAT DISAGREE
STRONGLY DISAGREE

SOMEWHAT DISAGREE
STRONGLY DISAGREE

Some people choose methods of treating remains that
are intended to lower the impact on the environment.
The following questions refer to these types of practices.

A. I would choose this method for
myself.

3

2

SECTION 3

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE

2

A. I would choose this method for
myself.

1

2

natural appearance. These cemeteries might contain
only plants and materials native to the region. Memorial
markers might be restricted to trees or naturally
occurring rocks to maintain the natural appearance.
Some areas of these cemeteries may also restrict visitor
access, similar to natural conservation areas, while other
areas may actively encourage visitors, similar to parks.

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

16) Some cemeteries are designed and maintained to have a

14) Some people choose to use a biodegradable casket or a
simple cloth shroud to wrap the body for burial rather
than a traditional casket to reduce the impact on the
environment.

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

8) Have you ever considered any types of burial options
other than a casketed burial or cremation?
1 Yes
2 No

VETERANS BURIAL BENEFITS SURVEY

2012

PAGE

4

Continue to next page 

VETERANS BURIAL BENEFITS SURVEY

SECTION 1
Please remember this survey is voluntary and
confidential. Your responses will be combined
with others and will not affect your benefits in
any way. Thank you for your participation.
1) Have you given much thought to planning your burial?
1 Thought about it a lot
2 Thought about it some
3 Thought about it hardly at all
4 Never thought about it
2) Before receiving this survey, how aware were you
of your burial benefits offered by the VA?
1 Very aware
2 Somewhat aware
3 Unaware
3) Have you done any of the following?
Please mark all that apply.
1
2
3

Visited a national cemetery
Attended a funeral ceremony at a national cemetery
Planned or helped to plan a funeral ceremony
for a Veteran

4) Have you discussed your burial preferences with your
spouse or other family members?
1 Yes
2 No
5) When thinking about the arrangements for your
funeral, what are your three most important
concerns?
1 My religious beliefs
2 My family’s or loved ones’ religious beliefs
3 My culture/heritage
4 My family’s or loved ones’ culture/heritage
5 Cost
6 That the ceremony be dignified
7 That the burial is familiar and/or traditional
8 Environmental impact
6) When choosing the location of your burial, what are

your two most important concerns?
1 It is near my residence
2 My remains will be near other deceased family
members or loved ones
3 It is located near other fallen service men and women
4 Family and friends are able to visit
5 Cost
6 Other:

PAGE

2

2012

7) How likely are you to choose burial in a national Veterans'
cemetery?
1 Very likely
2 Somewhat likely
3 Neither likely nor unlikely
4 Very unlikely
5 Definitely would not

VETERANS BURIAL BENEFITS SURVEY

11) Some people choose to be buried at sea, in which
their cremated or casketed remains are committed
to the ocean.
STRONGLY AGREE

1

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

9) The following burial options are currently offered by the VA.
If you had to choose one of these options today, which
option do you think you would choose?
1 In-ground casket burial
2 Cremation, in-ground burial
3 Cremation, columbarium (a vault for cremation remains)
4 Don’t know

C. The VA/NCA should offer this
method to Veterans.

1

2

2

2

3

3

3

STRONGLY AGREE

4

4

4

5

5

5

12) Some people choose to have their cremated
remains scattered in the air from a balloon or other
types of aircraft.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

SECTION 2

SOMEWHAT DISAGREE
STRONGLY DISAGREE

The next section asks you about burial methods
that are not currently offered by the VA. We are
interested in your opinions of these methods for yourself
and for other Veterans. For each of the following
statements, please indicate your agreement
or disagreement.
10) Some people choose to have their remains placed in
mausoleums, which are small buildings with walls, a roof
and sometimes a door. Mausoleums are used for storing
the remains of one or more people, either wholly above
ground or within a burial vault below the structure.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

4

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

3

4

5

SOMEWHAT DISAGREE
STRONGLY DISAGREE

STRONGLY AGREE

A. I would choose this method for
myself.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

D. This is method would uphold the
dignity and sanctity of the national
cemeteries.

1

2

3

4

5

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

15) Some cemeteries create dedicated sections that are
intended to lower the impact on the environment by
using only biodegradable caskets, as well as
biodegradable pesticides, natural fertilizers, and organic
gardening techniques. These sections may also have
some limitations on the use of concrete grave vaults,
site decoration, and memorial markers.

13) Some people choose embalming methods that utilize
only biodegradable materials, or they choose to have
their remains buried without embalming. If not
embalmed, remains are held in cooled facilities and/or
interred in a timely fashion.

A. I would choose this method
for myself.

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer
this method to Veterans.

1

2

3

4

5

D. This method would uphold
the dignity and sanctity of
the national cemeteries.

1

2

3

4

5

PAGE

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

D. This method would uphold the dignity
and sanctity of the national
cemeteries.

1

2

3

4

5

3

2

3

4

5

B. This kind of cemetery would be
a respectful and dignified way to
treat Veterans’ remains.

1

2

3

4

5

C. The VA/NCA should offer this kind
of cemetery to Veterans.

1

2

3

4

5

D. This kind of cemetery would
uphold the dignity and sanctity
of the national cemeteries.

1

2

3

4

5

SECTION 4
Next, we’d like you to think about ceremonies that
people perform at burials, including traditional rituals
related to their religion or cultural or ethnic background.
19) Are there any ceremonies, perhaps related to your cultural

heritage or religious or ethnic background, that you would
like to have at your burial?
Please write your answer.

20) Would the ceremony you wrote above include any of the
following at the gravesite?
Please mark all that apply.
1
2
3
4

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

Food
Flowers
Music
Leaving gifts or mementos

21) Would you still choose to be buried at a national Veterans'
cemetery if the kind of ceremony you wanted was
not allowed?
Please mark all that apply.
1 Yes
2 No
3 Not applicable, I do not want a ceremony.
4 Not applicable, I believe they allow the ceremony I want.
22) Why or why not?

Please write your answer.

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

1

2

3

4

5

B. This method would be a respectful
and dignified way to treat Veterans’
remains.

1

2

3

4

5

C. The VA/NCA should offer this
method to Veterans.

1

2

3

4

5

18) Are you aware of any other burial methods you and your

loved ones might consider that are not mentioned above?
Please write your answer.

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

1

cremated remains are used to create a new coral reef
habitat. In this process, cremated remains are incorporated
with cement to create a structure that is placed on the
sea floor in a designated reef reclamation area. The
structure may include a memorial plaque, and mourners
may visit the site by boat or by snorkeling or scuba diving.

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

5

A. I would choose this kind
of cemetery for myself.

17) Some people choose coral reef burials, in which their

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

1

2012

SOMEWHAT DISAGREE
STRONGLY DISAGREE

SOMEWHAT DISAGREE
STRONGLY DISAGREE

Some people choose methods of treating remains that
are intended to lower the impact on the environment.
The following questions refer to these types of practices.

A. I would choose this method for
myself.

3

2

SECTION 3

STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE

2

A. I would choose this method for
myself.

1

2

natural appearance. These cemeteries might contain
only plants and materials native to the region. Memorial
markers might be restricted to trees or naturally
occurring rocks to maintain the natural appearance.
Some areas of these cemeteries may also restrict visitor
access, similar to natural conservation areas, while other
areas may actively encourage visitors, similar to parks.

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this method for
myself.

16) Some cemeteries are designed and maintained to have a

14) Some people choose to use a biodegradable casket or a
simple cloth shroud to wrap the body for burial rather
than a traditional casket to reduce the impact on the
environment.

SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE

8) Have you ever considered any types of burial options
other than a casketed burial or cremation?
1 Yes
2 No

VETERANS BURIAL BENEFITS SURVEY

2012

PAGE

4

Continue to next page 

VETERANS BURIAL BENEFITS SURVEY

SECTION 5

26) Are you aware of any memorialization methods you

In addition to headstones, markers, and the Presidential
Certificate that NCA currently provides Veterans, there
may be additional methods to memorialize a Veteran’s
life and service to the country. Through recent advances
in technology, the following information could be
provided on a website and/or through handheld devices
so that loved ones, and other people they choose, have
access to it.
23) Specific information about your burial location, such as

directions to the gravesite and a picture of the headstone.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

24) Information about your military service, such as where

you enlisted, the rank you achieved, the places you were
stationed, and your military specialty and decorations.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT
DISAGREE
STRONGLY
DISAGREE
STRONGLY DISAGREE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

25) Information about your life after the military and

your family.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
STRONGLY
SOMEWHAT
DISAGREE
DISAGREE
STRONGLY DISAGREE

PAGE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

5

VETERANS BURIAL BENEFITS SURVEY

2012

and your loved ones might consider that are not
mentioned above?
Please write your answer.

30) What is your sex?
1 Male
2 Female
31) In what year were you born?
32) Are you Spanish, Hispanic, or Latino?

SECTION 6
Next, we would like to understand your background.
This information will not be used to identify you, but will
only be used to analyze survey responses.
27) In which branch of Service did you serve?
Please mark all that apply.
1 Air Force
2 Air Force Reserve
3 Air National Guard
4 Army
5 Army National Guard
6 Army Reserve
7 Coast Guard
8 Coast Guard Reserve
9 Marine Corps
10 Marine Corps Reserve
11 Navy
12 Navy Reserve

1

Yes

2

No

33) Which of the following best describes your race?
Please mark all that apply.
1 American Indian or Alaskan Native
2 Asian
3 Black or African American
4 Native Hawaiian or Other Pacific Islander
5 White

29) What was your pay grade at the time of your last
separation/retirement?
1 E1-E4
2 E5-E6
3 E7-E9
4 WO1-CW5
5 O1-O3
6 O4-O6
7 O7-O10

Continue to next page 

38) Are you currently receiving any of the following
benefits from the VA?
Please mark all that apply.
1 Eligibility for VA health care
2 VA health care facility locations
3 VA life insurance
4 VA home loans
5 VA education and training
6 VA vocational rehabilitation
7 VA burial and memorial benefits
8 VA disability compensation and pension
9 VA benefits for dependents and survivors
10 VA transition assistance
11 VA prescription benefits
12 Other:

Veterans Burial Benefits
SU RVE Y 2012

Purpose of Survey The Department of Veterans Affairs (VA) is conducting this survey to improve the quality of our current burial benefits program and guide its direction in the future. The information we collect will be used to help serve you
better, and you will learn about your burial benefits as you complete the survey.
You may also take this survey online by entering the following URL in your web browser: www.?????@?????.com.
Enter the following access code when prompted on the introduction screen: ??????.
Along with taking our survey, you can also help us by participating in a focus group or personal interview. If you would like
to participate in such an activity in your area, please provide us with your phone number and/or email address at the end
of the survey so that we can set up a time that is convenient for you.

34) What is the highest education or degree you
have received?
1

2
3
4
5

High school diploma/GED or other high
school equivalency
Some college credit, but no degree
Associate’s degree (e.g., A.A., A.S.)
Bachelor’s degree (e.g., B.A., B.S.)
Graduate or professional degree
(e.g., M.A., Ph.D., M.D., J.D.)

Thank you again for sharing your perspective. It will be
very helpful as we work to identify ways to honor our
Veterans; feedback from you and other Veterans will be
a big part of making improvements to the VA’s service
offerings. If you would like additional information,
please visit www.cem.va.gov

35) What was your total family income for 2011 before
taxes and deductions (gross income)?
1

28) When did you begin your first term of service?
1 September 2001 or later
2 August 1990 to August 2001 (includes Persian Gulf War)
3 May 1975 to July 1990
4 Vietnam Era (1964-1975)
5 February 1955 to July 1964
6 Korean War (July 1950 to January 1953)
7 January 1947 to June 1950
8 World War II (December 1941 to December 1945)
9 November 1941 or earlier

2012

2
3
4
5
6
7
8

Less than $10,000
$10,001 - $20,000
$20,001 - $30,000
$30,001 - $40,000
$40,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
More than $100,000

36) What is your current marital status?
1 Married, living with spouse
2 Married, not living with spouse
3 Widowed
4 Divorced
5 Legally separated
6 Never married
37) What is your religious affiliation?
Please mark only one.
1 Protestant
2 Catholic
3 Jewish
4 Muslim
5 Other religion (Please be specific)
6 No religion

PAGE

6

Along with this survey, we are conducting a series of interviews
and focus groups with Veterans to better understand their needs
regarding this important part of their lives. The topics covered in
these activities will be the same as those explored in this survey.
If you would like to participate in such an activity in your area,
please provide us your phone number and/or email address so
that we may set up a time that is convenient for you. Your
contact information will NOT be used for any other purpose than
to make these arrangements and, along with this survey, will be
destroyed at the conclusion of this project.
TELEPHONE NUMBER:

EMAIL:

Your Burial Benefits

Risk to Participants

As a Veteran, you may be eligible to be buried in a national
or state Veterans’ cemetery. Burial benefits include a gravesite in one of
the 131 national Veteran’s cemeteries or one of the
81 state Veterans’ cemeteries, opening and closing of the grave, perpetual
maintenance of the gravesite, a government-provided headstone or
marker, a U.S. flag, and a Presidential Memorial Certificate. These
benefits are available at no cost to the family and apply to both casketed
and cremated remains.

There is no measurable risk to participants associated with
completing the survey. Participation will in no way impact
your Veterans’ benefits.

Your spouse and/or dependents may also be eligible to be interred with
you in a shared gravesite at a national/state Veterans’ cemetery. This
benefit includes burial with the Veteran, perpetual maintenance of the
gravesite, and their names and dates of birth and death inscribed on the
Veteran’s headstone, at no cost to the family.

VA may not conduct, sponsor, or require the respondent to
respond to this collection of information unless it displays a
valid OMB Control Number. All responses to this collection
are voluntary. Public reporting burden for this collection of
information is estimated to average 15 minutes per response,
including the time necessary for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.
Failure to furnish the requested information will have no adverse
effect on any VA benefits to which you may be entitled.

Some Veterans may also be eligible for a Burial Allowance, a partial
reimbursement of an eligible Veteran’s burial and funeral costs. When
the cause of death is not service-related, the reimbursement generally
consists of two parts: (1) a burial and funeral expense allowance, and (2)
a plot or interment allowance. There are no benefits available to spouses
and dependents buried in a private cemetery. For more information on
your benefits, please visit the NCA website: www.cem.va.gov.
Use of Survey Results
The Department of Veterans Affairs will be using the information
collected from you to improve services and plan for the future needs of
Veterans and their families. Your responses will not impact your benefits
in any way.
Confidentiality of Data
All survey responses are kept strictly confidential and will only
be used to report group-level findings. Completion of this
survey is voluntary; if you complete the survey, you may skip
any question you do not wish to answer.

OMB Statement
OMB Control Number: To be determined
Public Reporting Burden Statement

Respondents are assured that answers given will be kept
confidential under the Privacy Act and will be used for research
purposes only. The information that respondents supply is
protected by law (the Privacy Act of 1974, 5 U.S.C. 522a and
section 5701 of the Title 38 of the United States Code). Disclosure
of information involves releases of statistical data
and other non-identifying data for the improvement of services
and associated administrative purposes. If you have comments
regarding this burden estimate or any aspects of this collection of
information, please call 1-866-216-0695 for mailing information
on where to send your comments.
Thank you for taking the time to complete this survey and for
helping improve the VA’s Burial Benefits Program. Continue>

VETERANS BURIAL BENEFITS SURVEY

SECTION 5

26) Are you aware of any memorialization methods you

In addition to headstones, markers, and the Presidential
Certificate that NCA currently provides Veterans, there
may be additional methods to memorialize a Veteran’s
life and service to the country. Through recent advances
in technology, the following information could be
provided on a website and/or through handheld devices
so that loved ones, and other people they choose, have
access to it.
23) Specific information about your burial location, such as

directions to the gravesite and a picture of the headstone.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

24) Information about your military service, such as where

you enlisted, the rank you achieved, the places you were
stationed, and your military specialty and decorations.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
SOMEWHAT
DISAGREE
STRONGLY
DISAGREE
STRONGLY DISAGREE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

25) Information about your life after the military and

your family.
STRONGLY AGREE
SOMEWHAT AGREE
NEITHER AGREE NOR DISAGREE
STRONGLY
SOMEWHAT
DISAGREE
DISAGREE
STRONGLY DISAGREE

PAGE

A. I would choose this kind of
memorialization for myself.

1

2

3

4

5

B. I believe other Veterans should have
this available to them at the VA’s
national cemeteries.

1

2

3

4

5

5

VETERANS BURIAL BENEFITS SURVEY

2012

and your loved ones might consider that are not
mentioned above?
Please write your answer.

30) What is your sex?
1 Male
2 Female
31) In what year were you born?
32) Are you Spanish, Hispanic, or Latino?

SECTION 6
Next, we would like to understand your background.
This information will not be used to identify you, but will
only be used to analyze survey responses.
27) In which branch of Service did you serve?
Please mark all that apply.
1 Air Force
2 Air Force Reserve
3 Air National Guard
4 Army
5 Army National Guard
6 Army Reserve
7 Coast Guard
8 Coast Guard Reserve
9 Marine Corps
10 Marine Corps Reserve
11 Navy
12 Navy Reserve

1

Yes

2

No

33) Which of the following best describes your race?
Please mark all that apply.
1 American Indian or Alaskan Native
2 Asian
3 Black or African American
4 Native Hawaiian or Other Pacific Islander
5 White

29) What was your pay grade at the time of your last
separation/retirement?
1 E1-E4
2 E5-E6
3 E7-E9
4 WO1-CW5
5 O1-O3
6 O4-O6
7 O7-O10

Continue to next page 

38) Are you currently receiving any of the following
benefits from the VA?
Please mark all that apply.
1 Eligibility for VA health care
2 VA health care facility locations
3 VA life insurance
4 VA home loans
5 VA education and training
6 VA vocational rehabilitation
7 VA burial and memorial benefits
8 VA disability compensation and pension
9 VA benefits for dependents and survivors
10 VA transition assistance
11 VA prescription benefits
12 Other:

Veterans Burial Benefits
SU RVE Y 2012

Purpose of Survey The Department of Veterans Affairs (VA) is conducting this survey to improve the quality of our current burial benefits program and guide its direction in the future. The information we collect will be used to help serve you
better, and you will learn about your burial benefits as you complete the survey.
You may also take this survey online by entering the following URL in your web browser: www.?????@?????.com.
Enter the following access code when prompted on the introduction screen: ??????.
Along with taking our survey, you can also help us by participating in a focus group or personal interview. If you would like
to participate in such an activity in your area, please provide us with your phone number and/or email address at the end
of the survey so that we can set up a time that is convenient for you.

34) What is the highest education or degree you
have received?
1

2
3
4
5

High school diploma/GED or other high
school equivalency
Some college credit, but no degree
Associate’s degree (e.g., A.A., A.S.)
Bachelor’s degree (e.g., B.A., B.S.)
Graduate or professional degree
(e.g., M.A., Ph.D., M.D., J.D.)

Thank you again for sharing your perspective. It will be
very helpful as we work to identify ways to honor our
Veterans; feedback from you and other Veterans will be
a big part of making improvements to the VA’s service
offerings. If you would like additional information,
please visit www.cem.va.gov

35) What was your total family income for 2011 before
taxes and deductions (gross income)?
1

28) When did you begin your first term of service?
1 September 2001 or later
2 August 1990 to August 2001 (includes Persian Gulf War)
3 May 1975 to July 1990
4 Vietnam Era (1964-1975)
5 February 1955 to July 1964
6 Korean War (July 1950 to January 1953)
7 January 1947 to June 1950
8 World War II (December 1941 to December 1945)
9 November 1941 or earlier

2012

2
3
4
5
6
7
8

Less than $10,000
$10,001 - $20,000
$20,001 - $30,000
$30,001 - $40,000
$40,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
More than $100,000

36) What is your current marital status?
1 Married, living with spouse
2 Married, not living with spouse
3 Widowed
4 Divorced
5 Legally separated
6 Never married
37) What is your religious affiliation?
Please mark only one.
1 Protestant
2 Catholic
3 Jewish
4 Muslim
5 Other religion (Please be specific)
6 No religion

PAGE

6

Along with this survey, we are conducting a series of interviews
and focus groups with Veterans to better understand their needs
regarding this important part of their lives. The topics covered in
these activities will be the same as those explored in this survey.
If you would like to participate in such an activity in your area,
please provide us your phone number and/or email address so
that we may set up a time that is convenient for you. Your
contact information will NOT be used for any other purpose than
to make these arrangements and, along with this survey, will be
destroyed at the conclusion of this project.
TELEPHONE NUMBER:

EMAIL:

Your Burial Benefits

Risk to Participants

As a Veteran, you may be eligible to be buried in a national
or state Veterans’ cemetery. Burial benefits include a gravesite in one of
the 131 national Veteran’s cemeteries or one of the
81 state Veterans’ cemeteries, opening and closing of the grave, perpetual
maintenance of the gravesite, a government-provided headstone or
marker, a U.S. flag, and a Presidential Memorial Certificate. These
benefits are available at no cost to the family and apply to both casketed
and cremated remains.

There is no measurable risk to participants associated with
completing the survey. Participation will in no way impact
your Veterans’ benefits.

Your spouse and/or dependents may also be eligible to be interred with
you in a shared gravesite at a national/state Veterans’ cemetery. This
benefit includes burial with the Veteran, perpetual maintenance of the
gravesite, and their names and dates of birth and death inscribed on the
Veteran’s headstone, at no cost to the family.

VA may not conduct, sponsor, or require the respondent to
respond to this collection of information unless it displays a
valid OMB Control Number. All responses to this collection
are voluntary. Public reporting burden for this collection of
information is estimated to average 15 minutes per response,
including the time necessary for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.
Failure to furnish the requested information will have no adverse
effect on any VA benefits to which you may be entitled.

Some Veterans may also be eligible for a Burial Allowance, a partial
reimbursement of an eligible Veteran’s burial and funeral costs. When
the cause of death is not service-related, the reimbursement generally
consists of two parts: (1) a burial and funeral expense allowance, and (2)
a plot or interment allowance. There are no benefits available to spouses
and dependents buried in a private cemetery. For more information on
your benefits, please visit the NCA website: www.cem.va.gov.
Use of Survey Results
The Department of Veterans Affairs will be using the information
collected from you to improve services and plan for the future needs of
Veterans and their families. Your responses will not impact your benefits
in any way.
Confidentiality of Data
All survey responses are kept strictly confidential and will only
be used to report group-level findings. Completion of this
survey is voluntary; if you complete the survey, you may skip
any question you do not wish to answer.

OMB Statement
OMB Control Number: To be determined
Public Reporting Burden Statement

Respondents are assured that answers given will be kept
confidential under the Privacy Act and will be used for research
purposes only. The information that respondents supply is
protected by law (the Privacy Act of 1974, 5 U.S.C. 522a and
section 5701 of the Title 38 of the United States Code). Disclosure
of information involves releases of statistical data
and other non-identifying data for the improvement of services
and associated administrative purposes. If you have comments
regarding this burden estimate or any aspects of this collection of
information, please call 1-866-216-0695 for mailing information
on where to send your comments.
Thank you for taking the time to complete this survey and for
helping improve the VA’s Burial Benefits Program. Continue>


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File Created2012-11-23

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