Ensuring Awareness of Benefits and Services of NCA

OMB Number: 2900-0876

Expiration: 2/28/2026

Estimated Burden:5 minutes

ww.va.gov/HOMELESS/.

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VA is very interested in the thoughts of Veterans, their family, friends, caregivers and survivors about burial concerns or desires. By answering these questions, you will help us understand awareness of burial options and benefits, end-of-life, and survivor benefits. Please take a few minutes to complete this survey so that we can better serve you and yours.

This survey uses the term ‘interment’ to mean any method of laying a body to rest: for example, burial in a grave or above ground site; ashes in an urn; or green burial.

You may take this survey more than once if you are a Veteran and also a family member, friend or survivor of a Veteran. When you are finished with the survey, simply exit, return to the email link, access the survey again and select a different response for the first question.

This voluntary survey will take you approximately 5 minutes to complete

1. For the purpose of this survey, would you describe yourself as:

   1. A Veteran ( Logic branch to Veteran questions)

   2. A family member, friend, or caregiver of a living Veteran (Logic branch to Family/Friend/Caregiver questions)

   3. A survivor of a Veteran (Logic branch to survivor questions)

Please answer these questions as a Veteran.

(Logic Following questions 2-15 only appear if respondent selects “A Veteran” to first question)

This survey uses the term ‘interment’ to mean any method of laying a body to rest: for example, burial in a grave or above ground site; ashes in an urn; or green burial.

2. How did you learn about VA burial and memorial benefits? (select all that apply)

   1. I don’t know anything about VA burial and memorial benefits

   2. Funeral home

   3. Events sponsored by VA

   4. Veterans Service Organizations

   5. Family, friends, colleagues, other Veterans

   6. DoD/VA Transition Assistance Program

   7. DoD Casualty Assistance Program

   8. VA.gov website

   9. News media

   10. Other (specify) _______

A VA-supported cemetery could be a National or grant-funded State, Tribal or Territorial cemetery

3. Before reading this question, were you aware that there are, in general, more burial and memorial benefits (including cost savings) if you choose a VA-supported rather than a non-VA supported cemetery?

1. Yes

2. No

3. Not sure

4. Before reading this question were you aware that there are still some burial and memorial benefits even if you choose a non-VA supported cemetery?

1. Yes

2. No

3. Not sure

5. Have you ever talked to your family/friends/caregiver about these VA end-of-life and survivor benefits? (select all that apply)

   1. Burial and memorial benefits for Veterans and eligible family members

   2. Bereavement counseling

   3. Dependency and Indemnity Compensation (DIC - tax-free monetary benefit for survivors of military Service members/Veterans who died in the line of duty service/related injury or disease)

   4. VA-provided pension (for those who are income/age eligible)

   5. Housebound allowance (higher pension for a surviving spouse who spends most of their time in a home due to a permanent disability)

   6. Aid & Attendance (higher pension for a surviving spouse who needs assistance with activities of daily living and/or are bedridden)

   7. VA life insurance

   8. Education benefits for beneficiaries

   9. No

5. What factors would affect your decision on how to be interred (traditional burial, cremation, green burial that allows for natural decomposition)? (select all that apply)

   1. My preferences

   2. Preferences of my family/friends/caregiver

   3. Cost

   4. Religious/cultural considerations

   5. Environmental considerations

   6. Other (specify) _______

5. What factors would affect your decision on where to be interred? (select all that apply)

   1. My preferences

   2. Preferences of my family/friends/caregivers

   3. Cost savings of VA-paid interment for me and eligible family members

   4. Rules of eligibility

   5. Wait times/timing of interment

   6. Distance of cemetery from home/family

   7. Types of interment available at a particular cemetery

   8. Location of other family members’ interment (past and future)

   9. Cemetery that honors Veteran service (VA supported cemetery)

   10. Perpetual care (cemetery maintains graves and grounds forever)

   11. Other (specify) _______

5. What do you consider to be a reasonable distance to travel to a cemetery to inter or visit your loved one?

   1. Up to 25 miles

   2. Up to 50 miles

   3. Up to 75 miles

   4. Up to 100 miles

   5. No limit

5. I trust VA, upon a Veteran’s death, to honor and commemorate their service and sacrifice to our Nation.

Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree

5. What is your race/ethnicity? (Select all that apply)

   1. Choose not to answer

b. Hispanic or Latino

c. White

4. Black or African American

5. Asian

6. Native Hawaiian or Other Pacific Islander

7. American Indian or Alaska Native

11. How would you describe your gender? (Select all that apply)

    1. Choose not to answer

2. Male

3. Female

4. Non-binary/third gender

5. Other

11. Which sexual orientation do you most identify with? (Select all that apply)

    1. Choose not to answer

    2. Heterosexual/straight

    3. Gay

    4. Lesbian

    5. Bisexual

    6. Queer

    7. Other

13. What is your current age?

    1. Choose not to answer

b. Under 20

c. 20-24

4. 25-29

5. 30-39

6. 40-49

7. 50-59

8. 60-69

9. 70 and over

13. Which religion do you associate yourself with? (Select all that apply)

    1. Catholic

    2. Protestant

    3. Mormon

    4. Muslim

    5. Jewish

    6. Hindu

    7. Buddhist

    8. Other (specify)_______

    9. None

    10. Don’t know

    11. Prefer not to answer

13. What is your zip code? _______

“To learn more about end-of-life planning benefits", Click here.  End-Of-Life Benefits | Veterans Affairs (va.gov)

Please answer these questions as the family/friend/caregiver of a Veteran.

(Logic Following questions 2-15 only appear if respondent selects “A family member, friend, or caregiver of a living Veteran” to first question)

This survey uses the term ‘interment’ to mean any method of laying a body to rest: for example, burial in a grave or above ground site; ashes in an urn; or green burial.

2. How did you learn about VA burial and memorial benefits? (select all that apply)

   1. I don’t know anything about VA burial and memorial benefits

   2. Funeral home

   3. Events sponsored by VA

   4. Veterans Service Organizations

   5. Family, friends, colleagues, my Veteran, other Veterans

   6. DoD/VA Transition Assistance Program

   7. DoD Casualty Assistance Program

   8. VA.gov website

   9. News media

   10. Other (specify) _______

A VA-supported cemetery could be a National or grant-funded State, Tribal or Territorial cemetery

2. Before reading this question, were you aware that there are, in general, more burial and memorial benefits (including cost savings) if you choose a VA-supported rather than a non-VA supported cemetery?

1. Yes

2. No

3. Not sure

2. Before reading this question, were you aware that there are still some burial and memorial benefits even if you choose a non-VA supported cemetery?

1. Yes

2. No

3. Not sure

5. Are you aware of these VA end-of-life and survivor benefits? (select all that apply)

1. Burial and memorial benefits for Veterans and eligible family members

2. Bereavement counseling

3. Dependency and Indemnity Compensation (DIC - tax-free monetary benefit for survivors of military Service members/Veterans who died in the line of duty service/related injury or disease)

4. VA-provided pension (for those who are income/age eligible)

5. Housebound allowance (higher pension for a surviving spouse who spends most of their time in a home due to a permanent disability)

6. Aid & Attendance (higher pension for a surviving spouse who needs assistance with activities of daily living and/or are bedridden)

7. VA life insurance

8. Education benefits for beneficiaries

9. No

6. What factors would affect your decision on how to inter your Veteran (traditional burial, cremation, green burial that allows for natural decomposition)? (select all that apply)

   1. Preferences of my Veteran

   2. My preferences

c. Preferences of my Veteran’s other family/friends/caregivers

4. .Cost

5. Environmental considerations

6. Religious/cultural considerations

7. Other (specify) _______

6. What factors would affect your decision on where to inter your Veteran? (select all that apply)

   1. Preferences of my Veteran

   2. My preferences

   3. Preferences of my Veteran’s other family/friends/caregivers

   4. Cost savings of VA-paid interment for me and eligible family members

   5. Rules of eligibility

   6. Wait times/timing of interment

   7. Distance of cemetery from home/family

   8. Types of interment available at a particular cemetery

   9. Location of other family members’ interment (past and future)

   10. Cemetery that honors Veteran service (VA supported cemetery)

   11. Perpetual care (cemetery maintains graves and grounds forever)

   12. Other (specify) _______

6. Has your Veteran shared their interment plans or preferences with you?

1. Yes

2. No

6. What do you consider to be a reasonable distance to travel to a cemetery to inter or visit your loved one?

   1. Up to 25 miles

   2. Up to 50 miles

   3. Up to 75 miles

   4. Up to 100 miles

   5. No limit

6. I trust VA, upon a Veteran’s death, to honor and commemorate their service and sacrifice to our Nation.

Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree

6. What is your race/ethnicity? (select all that apply)

1. Choose not to answer

2. Hispanic or Latino

3. White

4. Black or African American

5. Asian

6. Native Hawaiian or Other Pacific Islander

7. American Indian or Alaska Native

12. How would you describe your gender? (Select all that apply)

    1. Choose not to answer

2. Male

3. Female

4. Non-binary/third gender

5. Other

12. Which sexual orientation do you most identify with? (Select all that apply)

    1. Choose not to answer

2. Heterosexual/straight

3. Gay

4. Lesbian

5. Bisexual

6. Queer

7. Other

14. What is your current age?

1. Choose not to answer

2. Under 20

3. 20-24

4. 25-29

5. 30-39

6. 40-49

7. 50-59

8. 60-69

9. 70 and over

14. What is your zip code? _____

“To learn more about end-of-life planning benefits", Click here.  End-Of-Life Benefits | Veterans Affairs (va.gov)

Please answer these questions as the Survivor of a Veteran.

(Logic Following questions 2-15 only appear if respondent selects “A survivor of a Veteran” to first question)

This survey uses the term ‘interment’ to mean any method of laying a body to rest: for example, burial in a grave or above ground site; ashes in an urn; or green burial.

2. How did you learn about VA burial and memorial benefits? (select all that apply)

   1. I don’t know anything about VA burial and memorial benefits

   2. Funeral home

   3. Events sponsored by VA

   4. Veterans Service Organizations

   5. Family, friends, colleagues, my Veteran, other Veterans

   6. DoD/VA Transition Assistance Program

   7. DoD Casualty Assistance Program

   8. VA.gov website

   9. News media

   10. Other (specify) _______

For the next three questions, please think about the time when you made the decisions on your Veteran’s interment.

A VA-supported cemetery could be a National or grant-funded State, Tribal or Territorial cemetery

3. Before reading this question, were you aware that there are, in general, more burial and memorial benefits (including cost savings) if you choose a VA-supported rather than a non-VA supported cemetery?

1. Yes

2. No

3. Not sure

4. Were you aware that there were still some burial and memorial benefits even if you chose a non-VA supported cemetery?

1. Yes

2. No

3. Not sure

5. Were you aware of these VA end-of-life and survivor benefits? (select all that apply)

1. Burial and memorial benefits for Veterans and eligible family members

2. Bereavement counseling

3. Dependency and Indemnity Compensation (DIC - tax-free monetary benefit for survivors of military Service members/Veterans who died in the line of duty service/related injury or disease)

4. VA-provided pension (for those who are income/age eligible)

5. Housebound allowance (higher pension for a surviving spouse who spends most of their time in a home due to a permanent disability)

6. Aid & Attendance (higher pension for a surviving spouse who needs assistance with activities of daily living and/or are bedridden)

7. VA life insurance

8. Education benefits for beneficiaries

9. Not sure

10. No

5. What factors affected your decision on how to inter your Veteran (traditional burial, cremation, green burial that allows for natural decomposition)? (select all that apply)

   1. Preferences of my Veteran

   2. My preferences

   3. Preferences of my Veteran’s other family/friends/caregivers

   4. Cost

   5. Religious/cultural considerations

   6. Environmental considerations

   7. Other (specify) ____________

   8. Don’t remember

5. What factors affected your decision on where to inter your Veteran? (select all that apply)

   1. Preferences of my Veteran

   2. My preferences

   3. Preferences of my Veteran’s other family/friends/caregivers

   4. Cost savings of VA-paid interment for me and eligible family members

   5. Rules of eligibility

   6. Wait times/timing of interment

   7. Distance of cemetery from home/family

   8. Types of interment available at a particular cemetery

   9. Location of other family members’ interment (past and future)

j. Cemetery that honors Veteran service (VA supported cemetery)

k. Perpetual care (cemetery maintains graves and grounds forever)

l. Other (specify) _______

13. Don’t remember

5. Did your Veteran share their interment plans or preferences with you?

   1. Yes

   2. No

   3. Don’t remember

9. What do you consider to be a reasonable distance to travel to a cemetery to inter or visit your loved one?

1. Up to 25 miles

2. Up to 50 miles

3. Up to 75 miles

4. Up to 100 miles

5. No Limit

10. I trust VA, upon a Veteran’s death, to honor and commemorate their service and sacrifice to our Nation.

Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree

11. What is your race/ethnicity? (Select all that apply)

1. Choose not to answer

2. Hispanic or Latino

3. White

4. Black or African American

5. Asian

6. Native Hawaiian or Other Pacific Islander

7. American Indian or Alaska Native

11. How would you describe your gender? (Select all that apply)

1. Choose not to answer

2. Male

3. Female

4. Non-binary/third gender

5. Other

11. Which sexual orientation do you most identify with? (Select all that apply)

    1. Choose not to answer

2. Heterosexual/straight

3. Gay

4. Lesbian

5. Bisexual

6. Queer

7. Other

11. What is your current age?

    1. Choose not to answer

2. Under 20

3. 20-24

4. 25-29

5. 30-39

6. 40-49

7. 50-59

8. 60-69

9. 70 and over

11. What is your zip code? _____

“To learn more about end-of-life planning benefits", Click here.  End-Of-Life Benefits | Veterans Affairs (va.gov)

By filling out this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your experience with VA.

VA may utilize individual Veteran survey data from this survey or other sources to ensure the final scores truly and accurately represent the experiences of Veterans.

This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 5 minutes to review the instructions and complete this survey. The results of this survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be receiving. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private to the extent provided by law. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to [email protected]. VA will not disclose your personal information to third parties outside VA without your consent or when immediately responding to an expressed concern or need for immediate information or resources.