Additional documents needed to apply for benefits:

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1 At the time of your death, your spouse/next-of-kin (S/NOK) should not have to be concerned with making funeral decisions or trying to find all the paperwork necessary to process benefits and entitlements. This is something that should be discussed well in advance. The attached Retiree Casualty Assistance Checklist is for identifying desires and capturing important information necessary to process benefits and entitlements for your S/NOK as well as care for you. f cremation is desired, your SN OK needs to know that and you may want to contact the funeral director for instructions. Some may require a signed letter from the deceased of their cremation wishes. Furthermore, based on your beliefs, a clergyman may be either essential or merely of assistance. They could help with memorial planning, services, readings, pallbearers, etc. Some overlooked areas are membership in private associations/organizations. Sometimes these memberships also carry small life insurance policies. Some organizations or associations may even offer additional assistance to your spouse. n order to make this difficult time a little easier, it would help your family if you would have the handout completed and the referenced documents together in one place, preferably in a nonflammable box either at home or in a safe deposit box. f you keep these documents under lock and key, please ensure your SNOK knows where the key is or has the combination to the lock. t is helpful to have an agreement with a mortuary ahead of time. even ifno payments have been made. Thatway, things can fall into place more easily. All in all, this handout will assist your SN OK at a significantly emotional time. When the retiree passes away, the military retiree's family should contact their mortuary office and the Buckley Casualty Assistance Representative (CAR). The CAR will need the following information prior to scheduling an appointment: retiree's full name, rank, social security number, date of birth and date of death; spouse's full name, social security number, date of birth, phone number, local address and date of marriage. The CAR must wait to apply for benefits until the SN OK can provide a CERTFED COPY OF THE DEATH CERTFCATE, which takes 7 to 10 business days to obtain (longer if the death was not attended by medical personnel or ifthe coroner is involved). Ensure your S/NOK call the CAR for an appointment at once they have the death certificate. Additional documents needed to apply for benefits: DSCHARGE DOCUMENT: The DO-214 or other proof of honorable discharge must be provided to any National Cemetery for burial authorization. The last received, or retirement DO 214 indicates to the honors team the full degree of military honors to which the deceased is entitled. Also, ifthe survivors apply to the Veterans' Administration (V A) for Dependents' ndemnity Compensation (DC) for service-connected death benefits (meaning the deceased passed away from illnesses/injuries treated while on active duty), the DD-214 provides the dates and places of entry and release from service. f discharge was before 1 January 1950, the discharge document may have been called: WO AGO 53, WO AGO 55, WD AGO 53-55, NAVPERS 553, NAVMC 78PD OR NAVCG 553. RETREMENT ORDER: Can be used instead ofthe to show date and place of retirement. However, D D-214 is preferred.

2 RETREE ACCOUNT STATEMENT: Most retirees keep this document with their income tax infonnation. t shows the amount of Survivor Benefit Plan (SBP) benefits if the service member participated in this plan. This infonnation is also available from DF AS-CL at D CARDS: The retiree's D card must be destroyed to prevent unauthorized use in case it is lost or stolen. f married, the spouse must obtain a new card within approximately 40 days of their spouse's passing, regardless of how recently the card was obtained. After that period of time, the computer database will identify the survivor's card as invalid since the card shows the sponsor as living while the database shows the sponsor is deceased. This may result in a suspension of benefits (especially health benefits) until the situation is remedied. DVORCE CERTFCATE: This is needed if one of the parties was divorced, if a fonner spouse of the retiree was obtaining or could obtain military benefits through their eligibility or if the surviving spouse may be eligible for military benefits from a spouse other than the retiree. f divorce is a factor please ensure spouse brings a marriage certificate (not a license) for the current marriage. BANK ACCOUNT/DRECT DEPOST: fthe retiree participated in the Survivor Benefit Plan for the survivor, the survivor needs to bring to the appointment a voided check for the bank account to which the annuity is to be deposited. This will be attached to the direct deposit fonn accompanying the application process to show the correct routing and account numbers for deposit. These same forms that are completed at the Buckley Casualty Office are also mailed to your survivors by DF AS-CL within 2 weeks from their receipt of notice of the death. F THESE FORMS ARE COMPLETED THROUGH THE BUCKLEY CASUALTY OFFCE, THEY DO NOT NEED TO BE COMPLETED AGAN. t takes DFAS-CL approximately days to start annuity payments from the time the fonns are first submitted. This creates a gap in income from the time the retired pay stops. SOCAL SECURTY: Mortuaries are required by law to report deaths to Social Security. The spouse must also accomplish this in order to apply for widow/widower benefits with a phone call to Usually, the survivor's payment amount will be increased to the decedent's amount, if the decedent's amount was greater. There is also a one-time lump sum burial benefit of $255 payable to the surviving spouse or children who are receiving Social Security under the deceased's entitlement. Social Security does not pay in the month of death. Driving Directions: Enter Buckley AFB by the 6th Ave. Gate. Proceed on the same street (Aspen) until you reach the comer with the display aircraft. Our building, 606, is ahead on the right side, a large one-story building. Tum right (west, that is, toward the mountains) and take the first driveway on the left to the parking lot behind the building. Enter at the middle door, tum right, and proceed to room 140. Ask at the desk for the Casualty Office.

3 ~-- Retirees Casualty Assistance Checklist As of date: Retirees Name SSN Military Grade Branch of Service Date of Retirement Years of Service Place of Birth Date of Birth Address Phone City State Zip Code Spouse Name and (Maiden Name) SSN Date of Birth Place of Birth Date ofmarriage Place of Marriage Parents nformation Father's Name Date ofbirth Place of Birth Mother's Name and (Maiden Name) Date of Birth Place of Birth Children nformation Name SSN Date ofbirth Place of Birth Name SSN Date ofbirth Place of Birth Name SSN Date of Birth Place of Birth Name SSN Date of Birth Place of Birth Name SSN Date of Birth Place of Birth Family, Friends or Business Associates who may be helpful 1

4 Documents needed to claim death benefits (Check them off and note location of each) Copies ofreport(s) of separation from active duty (DD Form 214, etc.): Copies of retirement orders: Copies of birth and death certificates: Beneficiaries birth certificate(s) and marriage and/or divorce data: Social Security data (see Part ): VA insurance data (see Part J): Plus - You should always have the following documents on hand (note location of each) Updated will and letter of instructions: Location of Safe deposit box and key Names of banks, credit unions, etc and account numbers: Updated list of assets and liabilities: Adoption or naturalization papers (if applicable): Federal and State ncome Tax Returns Mortgage Paperwork Savings Bonds, Stocks, Securities Commercial Life nsurance Company Address Policy Number Value Company Address Policy Number Value Company Address Policy Number Value Funeral Home and Burial Arrangements i Name Phone Creamation or Burial Cemetery Church and Clergy Clergyman Hymns, Psalms, Scripture, Flowers, Pallbearers or Special Requests 2

5 ~ ~ ~. Part 1 - Veterans Affairs Data (ifapplicable) Disability c1aim# Remarks: VA nsurance policy Nr(s): File Nr: Type Amount $ Location of policies Any know paid-up additional V A insurance $ Other Remarks: As of Date Patients Data Card# Part Retirement Pay Data (See Retiree Account Statement RAS) Retiree pay data as ofdate: Gross Pay $ Deduction $ For Deduction $ For Deduction $ For Net Pay $ Taxable ncome $ Survivor coverage information Survivor Benefit Plan annuity $ SBP Base Amount $ Supplemental SBP (if any) $ RSFPP annuity $ Effective 3

6 Part - Social Security (when applicable) Social Security Claim # Month Filed Type ofbenefit(s) Beginning month of entitlement Amount monthly $ Bank and Account # (direct deposit) Note: No payment is payable for the month ofdeath (call local SSA office) Part V - Miscellaneous (Things to know and plan for upon death of a retiree) Disposition instructions for the body (burial, cremation, memorial service, obituary etc.)... nformation required for Death Certification. (DatelPlace of birth, Father's Name, Mother's Maiden Name, Education Level, Occupation, etc)..... nformation required for obituary notice (names, relation & locations of appropriate relatives, etc) Widows will need a new dependent D card (military, medical, commissary, base exchange, etc) Necessary changes in your DEERS program will have to be made (TRCARE, etc) t may take several months to clear estates (you may require at least 8 copies ofdeath certificate)... Contents of your safety deposit box should be know (and make sure the box number, its location and location of key are known)..... Direct deposit of Social Security benefits & military retirement payments (entitlements) must be immediately changed Named beneficiaries on insurance policies become very important (keep current) There may be some entitlement to burial benefits (headstone, payments, etc.)(check V A)... Check V A for Presidential Memorial Certificate... An American flag can be obtained (check VA and Post Office)..... The survivor should update appropriate will Extra credit cards should be destroyed or canceled.. Appropriate changes should be made to all joint ownerships Contact insurance companies as appropriate Be prepared to tum in Retirees D Card Note: Make every effort to retain "original" documents (Provide certified copies whenever possible) Note: Spouse/Next of Kin should have a copy of this document or know where to locate it. Consider letting a third party (family member) know where it is in case something should happen to both the retiree and spouse or Next of Kin at the same time. 4

7 Bank/Credit Union Account Number (Checking/Savings) Credit Cards (Place by those that have life insurance) Account Number Savings Bonds, Stocks and Securities (Location and Company to Contact) Memberships in Private Associations and Organizations (Names, Points ofcontact, Phone Numbers) -- 5

8 KEY TELEPHONE NUMBERS VETERAN'S ADMNSTRATON VETERAN'S HOME FTZSMMONS SOCAL SECURTY ADMNSTRA non DEFENSE FNANACE AND ACCOUNTNG SYSTEM OFFCE OF PERSONNEL MANAGEMENT OFFCE OF SERVCEMAN'S GROUP LFE NSURANCE NATONAL SERVCEMAN'S LFE NSURANCE THRFT SAVNGS PLAN TRCARE SERVCE CENTER TRCARE FOR LFE (OVER 65) TRCAREMAL ORDER PHARMACY BUCKLEY PHARMACY AR FORCE AD SOCETY AMERCAN RED CROSS BUCKLEY CASUALTY ASSSTANCE BUCKLEY RETREE ACTVTES OFFCE BUCKLEY ARMAN AND FAMLY READNESS CENTER BUCKLEY CHAPEL BUCKLEY D CARD SECTON BUCKLEY LEGAL OFFCE BUCKLEY SECURTY BUCKLEY AFB MAN GATE (6 TH AVE) BUCKLEY AFB OPERATOR '