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Burial Payment Request Form 2026
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- Click ‘Get Form’ to open the Burial Payment Request form in our editor.
- Begin by entering the Record Number and Social Security Number of the deceased in the designated fields.
- Fill in the Name of Deceased, Age at Death, Date of Death, and Date of Request. Ensure all details are accurate for processing.
- In the 'Request for Burial and/or Cremation Payment' section, indicate your relationship to the deceased by selecting from options such as Relative, Friend, or Other.
- Provide any payments you will contribute towards burial expenses in the Payments Toward Burial section. List additional contributors if applicable.
- Complete the Assets of the Deceased section by detailing available assets and their amounts.
- Sign and date the form at the bottom to certify that all information is true and correct before submitting it through our platform.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2019 | 4.8 Satisfied (98 Votes) | |
| 2019 | 4.3 Satisfied (36 Votes) | |
| 2019 | 4.8 Satisfied (69 Votes) | |
| 2017 | 4.8 Satisfied (108 Votes) | |
| 2016 | 4.8 Satisfied (238 Votes) | |
| 2016 | 4.8 Satisfied (145 Votes) | |
| 2016 | 4.8 Satisfied (114 Votes) | |
| 2016 | 4.3 Satisfied (176 Votes) | |
| 2016 | 4.5 Satisfied (53 Votes) | |
| 2016 | 4.1 Satisfied (20 Votes) | |
| 2014 | 4.8 Satisfied (178 Votes) | |
| 2011 | 4.2 Satisfied (51 Votes) | |
| 2011 | 4.8 Satisfied (61 Votes) | |
| 2011 | 4.8 Satisfied (86 Votes) | |
| 2010 | 4.9 Satisfied (481 Votes) |
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When the CAO receives your request, it will determine if the following criteria are met before sending a Burial Payment Request Form (PA 118) to the requestor:.Read more
The form to request payment shall be submitted to the Department within 30 days of the date of death with the following exceptions: (1) When there are unusual