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Benefit Forms

Insurance Forms

 

Application for Reinstatement of Coverage (VGLI)
SGL 180 | Adobe PDF
Use this Form: To reinstate a lapsed Veterans' Group Life Insurance policy.

Claim for Death Benefits (SGLI/VGLI)
SGLV 8283 | Adobe PDF
Use this Form: To claim Servicemembers' Group Life Insuarnce or Veterans' Group Life Insurance proceeds for a deceased policyholder.

Claim for Family Coverage Death Benefits (SGLI)
SGLV 8283A | Adobe PDF
Use this Form: To claim FSGLI proceeds for a deceased spouse or dependent.

Servicemember/Veteran Accelerated Benefits Option Form
SGLV 8284 | Adobe PDF
Use this Form: To request an advance insurance payment for a service member or veteran that is terminally ill.

Servicemembers' Group Life Insurance Family Coverage - Accelerated Benefits Option
SGLV 8286 | Adobe PDF
Use this Form: To reduce or decline SGLI coverage OR to designate or update the beneficiary on a SGLI policy.

Family Coverage Election (SGLI)
SGLV 8286A | Adobe PDF
Use this Form: To reduce or decline FSGLI coverage.

Application for Servicemembers' Group Life Insurance Traumatic Injury Protection Program (TSGLI) Benefits (Payments)
SGLV 8600 | Adobe PDF
Use this Form: To certify a traumatic injury for TSGLI coverage.

Report of Death of a Family Member
SGLV 8700 | Adobe PDF
Use this Form: If you are in a military casualty and personnel offices. If not, please contact your casualty or personnel office to report the death of a family member.

Application for Veterans' Group Life Insurance
SGLV 8714 | Adobe PDF | Apply Online
Use this Form: To apply for VGLI insurance.

Application for Servicemembers' Group Life Insurance Disability Extension
SGLV 8715 | Adobe PDF 
Use this Form: To apply for a free extension (up to two years) of SGLI coverage if you are a totally disabled at time of discharge.

VGLI Beneficiary Designation/Change
SGLV 8721 | Adobe PDF
Use this Form: To designate or change the beneficiary for your VGLI policy.

Servicemembers' Group Life Insurance Supplemental SGLI Beneficiary Form
SGLV 8286S | Adobe PDF
Use this Form: As a continuation to SGLV 8286 to designate additional SGLI beneficiaries.

VA Life Insurance Forms

Certificate Showing Residence and Heirs of Deceased Veteran or Beneficiary
VA Form 29-541 | Adobe PDF
Use this Form: To determine eligibility for a death benefit.

Notice of Lapse and Application for Reinstatement
VA Form 29-389 | Adobe PDF
Use this Form: As an application for reinstatement of Government Life Insurance after 6 months from date of lapse.

Application for Reinstatement (Non Medical - Comparative Health Statement)
VA Form 29-353 | Adobe PDF
Use this Form: As an application for reinstatement of Government Life Insurance less than 6 months from date of lapse.

Application for Change of Permanent Plan (Medical)
VA Form 29-1549 | Adobe PDF
Use this Form: To change to a policy with a lower reserve rate.

Insurance Deduction Authorization
VA Form 29-888 | Adobe PDF
Use this Form: To authorize deduction from benefit payments for Government Life Insurance premium payment.

VA MATIC Enrollment/Change
VA Form 29-0165 | Adobe PDF
Use this Form: To enroll in VA MATIC or to make a change to an existing account.

VA MATIC Authorization
VA Form 29-0532-1 | Adobe PDF
Use this Form: To preauthorize automatic electronic funds transfer for monthly Government Life Insurance premium payment.

Application for Ordinary Life Insurance
VA Form 29-8485 | Adobe PDF
Use this Form: For replacement insurance for modified life reduced at age 65 (National Service Life Insurance).

Designation of Beneficiary - Government Life Insurance
VA Form 29-336 | Adobe PDF
Use this Form: For designation of beneficiary for Government Life Insurance.

Application for Cash Surrender/Application for Policy Loan Government Life Insurance
VA Form 29-1546 | Adobe PDF
Use this Form: To apply for cash surrender of your insurance policy or to apply for a loan from your insurance policy.

Claim for One Sum Payment
VA Form 29-4125 | Adobe PDF
Use this Form: As a Beneficiary to claim one sum payment of government life insurance.

Application for Service-Disabled Veterans Insurance
VA Form 29-4364 | Adobe PDF
Use this Form: To apply for Service-Disabled Veterans Insurance.

Claim for Disability Insurance Benefits
VA Form 29-357 | Adobe PDF
Use this Form: If you have government life insurance and have become totally disabled.

Veterans Mortgage Life Insurance Inquiry
VA Form 29-0543 | Adobe PDF
Use this Form: To report recent changes in the status of your mortgage.

Veterans Mortgage Life Insurance
VA Form 29-0563 | Adobe PDF
Use this Form: To update your Veterans Mortgage Life Insurance of a change of address.

Application for Supplemental Service-Disabled Veterans Insurance (SRH)
VA Form 29-0188 | Adobe PDF
Use this Form: To apply for up to $30,000 in additional coverage.

Application for Ordinary Life Insurance
VA Form 29-8485a | Adobe PDF
Use this Form: For replacement insurance for modified life reduced at age 70 for National Service Life Insurance.

Veterans Mortgage Life Insurance Statement
VA Form 29-8636 | Adobe PDF
Use this Form: To apply for Veterans Mortgage Life Insurance.

Application for Reinstatement Insurance Lapsed More Than 6 Months
VA Form 29-352 | Adobe PDF
Use this Form: For reinstatement of your Government Life Insurance and/or Total Disability Income Provision when application is made more than 6 month after the date of lapse regardless of age.

Application For Protection Of Commercial Life Insurance Policy
VA Form 29-380 | Adobe PDF
Use this Form: To apply for protection of a commercial life insurance policy.

Claim for Monthly Payments
VA Form 29-4125a | Adobe PDF
Use this Form: To apply for settlement options for National Service Life Insurance policy.