29 4364-2026

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The document outlines the application process for Service-Disabled Veterans Insurance (S-DVI), which provides up to $10,000 in life insurance for eligible veterans. Eligibility criteria include being released from active service under honorable conditions, having a new service-connected disability within the last two years, and being in good health aside from the service-connected disability. The document also discusses premium costs, application submission methods, and provides contact information for further inquiries.

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Click ‘Get Form’ to open the 29 4364 application in the editor.
Begin by filling in your Name and Mailing Address for Insurance Purposes. Ensure that you provide your full name and complete mailing address accurately.
In the Beneficiary Designation section, list each principal beneficiary's complete name, Social Security Number, relationship to you, and the share of payment they will receive. Remember to include contingent beneficiaries if applicable.
Complete the personal information section by entering your VA Claim Number (if any), Social Security Number, Date of Birth, Daytime Telephone Number, and Email address.
Specify the amount of insurance you are applying for along with the plan and monthly premium details as outlined in Pamphlet 29-9.
Answer questions regarding your employment status and any health conditions. Be thorough in your explanations where required.
Finally, review all entries for accuracy before signing and dating the application at the bottom of the form.

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