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This document serves as an application to request dependent's benefits and/or burial benefits due to a deceased employee resulting from occupational exposure or disease related to their employment.

How to fill out application for hearing-dependents benefits

How to fill out Application for Hearing-Dependent’s Benefits and/or Burial Benefits

1. Obtain the Application for Hearing-Dependent’s Benefits and/or Burial Benefits form from the relevant agency's website or office.
2. Read the instructions carefully to understand the eligibility requirements and necessary documentation.
3. Fill out the applicant's personal information, including name, address, and Social Security number.
4. Provide the required information about the deceased individual, including their name, date of birth, and date of death.
5. Specify the benefits being requested (Hearing-Dependent’s Benefits or Burial Benefits) and provide any additional information required for each.
6. Attach the necessary documentation, such as death certificates, proof of relationship, and any other required forms.
7. Review the completed application to ensure all sections are filled out accurately.
8. Sign and date the application form.
9. Submit the application to the appropriate agency via the designated method (mail, online submission, in-person).

Who needs Application for Hearing-Dependent’s Benefits and/or Burial Benefits?

1. Individuals who are dependents of a deceased person who qualified for hearing-dependent benefits.
2. Family members seeking benefits for burial expenses after the death of a qualifying individual.
3. Survivors of deceased workers or retirees who had benefits under a certain program.

People Also Ask about

How to apply for burial assistance?

For low-income residents, counties may offer modest assistance to cover a basic funeral or cremation with a service. Contact the California Department of Health office in the county of residence to apply. You can also read our guide to final expense and burial insurance in California.

How much does the VA pay for a burial?

Reimbursement of Burial Expenses: VA will pay a burial allowance up to $2,000 if the Veteran's death is service-connected. In such cases, the person who bore the Veteran's burial expenses may claim reimbursement from VA.

Do all Veterans qualify for VA burial benefits?

Burial in a VA national cemetery is open to all members of the armed forces and Veterans who have met minimum active duty service requirements, as applicable by law and were discharged under conditions other than dishonorable.

How do I apply for DIC survivors pension and or accrued benefits?

If you're the surviving spouse or child of a veteran, fill out VA Form 21P-534EZ, “Application for DIC, Survivor's Pension and/or Accrued Benefits.” If you're a surviving parent, fill out VA Form 21P-535, “Application for Dependency and Indemnity Compensation by Parent(s).”

Who qualifies for Veterans death benefits?

The Veteran must not have received a dishonorable discharge, and one of these circumstances must be true: The Veteran died as a result of a service-connected disability (a disability related to service), or. The Veteran died while getting VA care, either at a VA facility or at a facility contracted by VA, or.

How many years do you have to be in the military to get a military funeral?

Former military members who completed at least one term of enlistment or period of initial obligated service in the Selected Reserve and departed under conditions other than dishonorable.

What qualifies a Veteran for burial benefits?

A veteran may be eligible for a VA burial allowance if: the veteran paid for a veteran's burial or funeral; and. the veteran has not been reimbursed by another government agency or some other source, such as the deceased veteran's employer; and. the veteran was discharged under conditions other than dishonorable.

How do I claim burial benefits?

Claimants must be issued an SS Number and registered in the SSS website to be able to apply for funeral benefit through the My.SSS portal. Claimant must have a disbursement account enrolled in the Disbursement Account Enrollment Module (DAEM) of the My.SSS portal in the SSS website.

For pdfFiller’s FAQs

What is Application for Hearing-Dependent’s Benefits and/or Burial Benefits?

The Application for Hearing-Dependent’s Benefits and/or Burial Benefits is a formal request made by eligible individuals to receive financial support for hearing-related expenses and burial costs associated with a deceased dependent.

Who is required to file Application for Hearing-Dependent’s Benefits and/or Burial Benefits?

Individuals who are legal guardians or family members of a hearing-dependent individual who has passed away or requires benefits must file the application.

How to fill out Application for Hearing-Dependent’s Benefits and/or Burial Benefits?

To fill out the application, applicants need to provide personal information, details of the hearing-dependent individual, and relevant documentation regarding burial expenses and eligibility requirements.

What is the purpose of Application for Hearing-Dependent’s Benefits and/or Burial Benefits?

The purpose of the application is to ensure that eligible individuals receive necessary financial assistance for hearing-related needs and cover burial costs for their dependents.

What information must be reported on Application for Hearing-Dependent’s Benefits and/or Burial Benefits?

The application must report personal identification information, relationship to the dependent, details of hearing impairment, burial expenses incurred, and any other required documentation related to eligibility.