MILITARY FUNERAL HONORS REQUEST
MILITARY FUNERAL HONORS REQUEST
US ARMY PERSONNEL (Honorably Discharged)
Maine Military Funeral Honors Program, Augusta Armory, Augusta, ME 04330
Fax: (207) 626-7804 Office: 1-800-958-5967
1. Funeral Director: ______________________Phone: ________________ Fax: _______________
Name/address of funeral home: ________________________________________________________
2. Deceased service member information: (Please mark response where applicable)
Full name: ______________________________________ highest rank held: ___________________
SSN: _______________ Army Retiree: ____ Army Vet: ____ From: __________ To: __________
Honorable discharge document attached (DD Form 214, NGB Form 22 or Certificate):____________________
Date of death: _______________
3. Next of kin (NOK) to whom the flag will be presented during the honors ceremony:
Name: _______________________ Relationship: _______________ Phone: ________________
Mailing address: _________________________________________________________________
4. Military Funeral Honors Ceremony location: Funeral Home: ___ Church: ___ Cemetery: ____ Other: _____________________________
Date/Time of Military Funeral Honors Ceremony: __________________ / __________________
(Date) (Time)
How is the Veteran being interred: Casket: ____ Cremation: ____
Report Location for Honors Team: _____________________________________________________
Complete Address: __________________________________________________________________
Directions, if necessary: ______________________________________________________________
__________________________________________________________________________________
DO YOU HAVE AN INTERMENT FLAG AVAILABLE? Yes: _____ No: _____
If a flag is not available, you as the funeral director must obtain a US interment flag from the local VA Office or Post Office. The Honors Team does not generally provide flags, but will in unique situations.
5. Military Honors: A minimum of a two-soldier team will fold and present the flag and sound Taps.
Note: If you have a problem acquiring Military Funeral Honors for ANY eligible Veteran, do not hesitate to contact this office. We can and will provide appropriate Military Honors to any branch of service Veterans. We will do our very best to provide a representative of the deceased Veteran’s branch of service.
**PLEASE ALLOW A MINIMUM OF 48 HOURS NOTICE IF POSSIBLE**
THIS FORM MUST BE FAXED: (207) 626-7804 061213
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