Online Cemetery Registration Form - Nevada Department of Veterans Services

Select Cemetery

Person completing this form?

Email address

Veteran Applicant Name

Prefix First Middle Last Suffix

Veteran Applicant Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Hidden

Veteran Applicant SSN#*

Veteran Applicant Date of Birth

Veteran Applicant Marital Status*

Veteran Applicant Gender

Veteran Applicant Phone

Is a Spouse to be interred with Veteran?

(If Spouse is to be interred, a copy of the marriage certificate is required)

Spouse or Next of Kin Name

Prefix First Last

Relationship to veteran

Spouse or Next of Kin Phone

Spouse or Next of Kin Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Hidden

Military Service Number

Military Service Highest Rank

Military Service Branch

Upload DD-214, Marriage Certificate, or Equivalent*

Drop files here or

Max. file size: 10 MB, Max. files: 4.

Upload scans or legible pictures of required documents.

Comments?