Va Form 29 4125

A Claim for One Sum Payment Government Life Insurance is a document, formally known as a VA Form 29-145, is used by the Department of Veterans Affairs to process the life insurance of a deceased veteran. This form is used by a veteran’s beneficiary who needs to claim the life insurance policy. This form collects information from the beneficiary and the veteran, using information such as the veteran and beneficiary’s names, the date the veteran died, the insurance policy number and the insurance file number. In addition to the amount that the life insurance policy was for, the VA will need a death certificate to process such a claim.

What is a 29 4125?

A VA Form 29-4125 is known as a Claim for One Sum Payment Government Life Insurance. This claim form is used by the United States Department of Veterans Affairs and the Veterans Benefits Administration. This form will be used by someone who needs to claim the life insurance held by a deceased veteran.
This form will require information about the veteran and their beneficiary. This will include their names, insurance policy number, insurance file number, date of death, and the amount the beneficiary is eligible for. The beneficiary will also need to include legal documentation, such as a death certificate, with this form. This will allow the VA to verify the date of death and distribute the life insurance benefits. 

Most Common Uses

The VA Form 29-4125 is commonly used by a beneficiary to claim the life insurance benefits that are owed to a deceased veteran.

Components of a 29 4125

A VA Form 29-4125 contains the following sections:

  • Veterans Information
  • Beneficiary’s Information
  • Certification
  • Financial Institution Information

You should complete this form and mail it or fax it to:
VA Insurance Center, P.O. Box 7208, Philadelphia, PA 19101
If you have questions about the form, you can call the toll free number 1-800-669-8477.  OMB Approved No. 2900-0060. Collection of information asked on this form is in order to verify eligibility for VA benefits and under the authority of 38 U.S.C. 5902.  
The VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses identified in the VA system of records, 36VA00, Veterans and Armed Forces Personnel U.S. Government Life Insurance Records-VA, and published in the Federal Register.

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Sample Va Form 29 4125


Sample Va Form 29 4125

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