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Department of Defense form 1375. Official designation: DD Form 1375, Request for Payment of Funeral and/or Interment Expenses, October 2003. Purpose: Request for Payment of Funeral and/or Interment Expenses. Current edition not stated, status not stated.
Issued under not stated, with not stated as proponent. A DD number marks a Department-wide instrument: the same blank form serves every military department and the defense agencies, rather than one service alone.
Common users: service members regardless of branch, Defense civilian staff, and the offices that file, verify or retain the finished document.
Submission follows the schedule set by not stated and by local implementing procedures. This page provides the blank form for download and general orientation only.
The download set covers PDF. Document length is 1 pages with about 31 entry fields.
Free download applies to every format listed. Any current pdf reader opens the pdf files, though field behaviour is most reliable in a full desktop reader rather than a browser preview.
What the form asks for
- 1. Military Activity preparing this form. a. Name.
- 1.b. Address. Street, City, State and ZIP Code.
- 2. Military activity form is to be mailed to for payment. a. Name.
- 2.b. Address. Street, City, State and ZIP Code.
- 3. Name of Decedent. Last Name, First Name, Middle Initial.
- 4. Pay Grade and/or Rank.
- 5. Service Number and/or Social Security Number.
- 6. Place of death. City, State, Country.
- 7. Date of Death. 4 digit year, 2 digit month, 2 digit day.
- 8. Name of Claimant. Last Name, First Name, Middle Initial.
- 9. Relationship.
- 10. Funeral Home and/or National Cemetery. a. Name.
- 10.b. Address. Street, City, State and ZIP Code.
- 11. If Yes, enter name of contracting activity.
- 12. Cemetery, Mausoleum or other Disposition. a. Name.
- 12.b. Address. Street, City, State and ZIP Code.
- 14. Interment Costs. Amount claimed.
- 15. Funeral arrangement costs. Amount claimed.
- 16. Shipping cost of remains. Amount claimed.
- 17. Shipment of remains. a. Shipped from (City and State).
- 17.b. Shipped To. City and State.
- 18.a. Name of Payee (print or type).
- 18.b. Taxpayer ID number or SSN.
- 18.c. Address of Payee. Street, City, State and ZIP Code.
Order of completion: identification block first, substantive entries second, certification and signature last. The blank is laid out in that sequence and the sequence is not arbitrary — later entries often depend on data established in the header.
The current edition is not stated. Superseded editions of DD forms are frequently rejected at the receiving office, since Department-wide forms change centrally and older layouts lose their field correspondence. Edition date appears in the lower corner of the printed blank.
Instructions printed on the form or in not stated govern individual field entries. Where the two differ, the governing publication controls.
After completion, the copy goes to the office designated by not stated or by local procedure. Retention of a personal copy is ordinary practice and costs nothing.
Related documents are located by series and number. DD forms sit in a single Department-wide sequence, so a form referenced inside DD Form 1375 is normally found by its number alone, without regard to service.
A DD number and a DA number may appear in the same instruction without being related. DA forms belong to the Army alone; DD forms belong to the Department and are administered at Department level. The sequences are independent.
Forms are reissued for several reasons: directive revision, changed data requirements, updated notice language. Confirming not stated at the moment of download covers the risk.
Scope of this page: distribution of a published form and description of its contents. It offers no legal guidance and no assurance regarding any particular submission. Direct procedural questions to not stated, to the servicing personnel office, or to the office designated in not stated.
Questions and answers
- What is DD Form 1375?
- DD Form 1375, Request for Payment of Funeral and/or Interment Expenses, October 2003
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?