Marker Information for Purchase or Placement 2018 Price List

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1 Marker Information for Purchase or Placement 2018 Price List 5400 Valentine Road Ventura, California fax License # FD2156 Ventura County s ONLY Historic District Cemetery providing affordable cremation and burial services. Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 1

2 Ivy Lawn Memorial Park & Funeral Home Marker Information for Purchase or Placement Purchasing a grave marker, crypt plate, or niche plate is an expensive and significant purchase. It deserves time and attention as many choices and decisions are necessary. The purchaser should know this is a long term, and possible permanent choice that will have a lasting effect. When purchasing a grave marker, niche plate, crypt plate or other choices available the consumer should know the requirements of Ivy Lawn Memorial Park & Funeral Home. Purchaser is responsible to ensure all requirements are met. GENERAL INFORMATION The following apply regardless of the place of purchase: The location of your burial property determines your choices; All fees must be paid to Ivy Lawn Memorial Park & Funeral Home PRIOR to placement or acceptance of a marker; Signed forms must be received by Ivy Lawn Memorial Park & Funeral Home PRIOR to placement or acceptance of a marker; If purchased through an outside company additional steps for acceptance will apply. If marker is damaged purchaser is responsible to follow up with the company they purchased from. Please consult our Rules and Regulations for details. FEES: Fees are required when ordering or setting any marker. Certain fees are required on all markers. Other fees may apply and are determined by the location of the property. If additional services by our staff is necessary specific fees may be required in addition to the required fees. Reference our Price List for exact amounts. Required fees that apply to all markers are: Endowment Care is required on all markers. Setting Fee is required for every marker. FORMS: Marker setting is a legal process. Purchaser must allow for time to complete all forms and provide executed documents to Ivy Lawn Memorial Park & Funeral Home. These forms must be provided prior to setting, removing, or making changes to any marker. Every situation is unique. Please consult one of our counselors to determine what documents are required PRIOR to purchase. page 1 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 2

3 AUTHORIZATION: You must provide signed authorizations PRIOR to setting or acceptance. The authority to take any action for a marker lies with the deedholder and/or the next of kin known as the authorizing agent. It is common to have multiple agents. ALL agents must sign. It can be complicated if there are multiple burials in one location. PAYMENT: All fees must be paid PRIOR to acceptance of any marker or setting of any marker. PLACEMENT: Ivy Lawn Memorial Park & Funeral Home will set ALL markers. Scheduling is at our discretion. Setting is based on many factors but will be done at the earliest possible time. Family may arrange for a witness placement but witnessing fees will apply. MAINTENANCE: The purchaser accepts responsibility for the maintenance and appearance of any marker including all costs of maintenance. Time and exposure to the elements will change the appearance of a marker. Paint will fade, a marker may require highlighting and/or cleaning, or repair may be needed to keep up the appearance of the marker. Ivy Lawn Memorial Park & Funeral DOES NOT maintain any marker. We strictly maintain the lawn and area by the marker. EXISTING MARKER: Changes made to an existing marker require the same attention to forms and payment as a new marker. Ivy Lawn Memorial Park & Funeral Home can help arrange for repair, maintenance or updating an existing marker, however there are additional costs involved with these decisions and strict authorizations must be obtained prior to ordering them. Please consult our Rules and Regulations for details. ENDOWMENT CARE: This is a one-time fee paid at time of purchase. It is NOT for the current care of any marker. It is entirely for the FUTURE maintenance of the cemetery and marker areas. It is placed in a trust fund and will cover the future costs to maintain the cemetery when full. NON RESPONSIBILITY FOR DAMAGE While Ivy Lawn Memorial Park & Funeral Home will exercise reasonable care to protect markers, raised letters, emblems, carvings on all memorials, structures, any property, we are NOT RESPONSIBLE for damage or injury caused by the elements, an act of God, common enemy, thieves, vandals, strikers, malicious mischief makers, explosions, unavoidable accidents, invasions, insurrections, riots, or any military or civil authority, whether direct or collateral damage. I have read, understand, and accept the terms above: Signature: Date: page 2 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 3

4 Authorization to Install Marker This form must be signed by the deed holder(s) to the property location described below and the Authorizing Agent(s) (following California Health and Safety Code 7100 as guidance). File#: Ivy Lawn Memorial Park & Funeral Home, FD Valentine Road Ventura, CA Phone FAX Name(s) of deceased: Property location: Size/color of marker: Person authorized to order marker: Name and Relationship to Decedent Marker to be ordered at: Ivy Lawn Memorial Park or Name of Funeral Home or Monument Company If marker is ordered from a source other than Ivy Lawn Memorial Park, you must provide the company s complete address and phone number. (In the event of defective material and/or workmanship of this marker, it is the purchaser s responsibility to contact the supplier for replacement.) AUTHORIZATION Including this marker, how many markers are on this grave? See Rules and Regulations 4.01 I/we the deed holder(s) and/or authorizing agent(s) was/were advised about Ivy Lawn s rules and regulation 4.10 Non-responsibility for Damage, which states: * While Ivy Lawn will exercise reasonable care to protect raised lettering, carving, or emblems on any memorial, or other structure, on any property, it disclaims responsibility for any damage or injury from causes beyond its reasonable control, and especially from damage caused by the elements, an act of God, common enemy, thieves, vandals, strikers, malicious mischief makers, explosions, unavoidable accidents, invasions, insurrections, riots, or order of military or civil authority, whether the damage be direct or collateral. *This statement includes non-responsibility for damage to photo etch and/or photo medallions. page 3 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 4

5 I/we the deed holder(s) and/or authorizing agent(s) hereby authorize agree and instruct Ivy Lawn Memorial Park to install the marker as described above. Printed Name/relationship to decedent(s) Signature Date signed Printed Name/relationship to decedent(s) Signature Date signed Printed Name/relationship to decedent(s) Signature Date signed Printed Name/relationship to decedent(s) Signature Date signed Accepted by:, Ivy Lawn Memorial Park page 4 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 5

6 Creating a Grave Marker You are creating an everlasting memory by selecting a memorial that will be handcrafted by caring and highly skilled craftsmen. Ivy Lawn Memorial Park & Funeral Home offers many choices of styles. Sizes and material are dependent upon the location of your grave or niche. Choose Granite or Bronze GRANITE: Granite is among the world s most beautiful and prestigious natural stones. Granite has an intrinsic natural value depending on color and place of origin. The most highly-prized granites, Blue Pearl, Mahogany and Ebony, are imported from many parts of the world. Many families prefer Ebony because detailed family photos can be etched into the black granite and enjoyed for generations to come. Granite is an impressive way to create a unique and beautiful memorial. The selection of lustrous granite colors are shown below. Ebony Mahogany Gray Blue Pearl Serenity Red Imperial Grey BRONZE: Standard bronze colors include: Dark Brown, Light Brown & Black. For an additional cost Cherry, Blue and Green are also available. As a special order, we offer light & dark oxidized bronze for an additional 20% above our standard pricing. Memorials are available in a variety of finish colors which are normally applied in the form of paint onto the surface of the bronze. This is the process for standard memorials. At an additional cost, we offer the oxidization process which colors the bronze to its natural dark brown finish. BORDERS INCLUDE: Rock, Woodgrain, Greek Key, Painted Bevel (all borders are not available in all sizes). Narrow polished bevel:... $ additional cost Wide polished bevel: wide... $ additional cost Scenic designs are available at an additional cost. Standard shipping time is 3 6 weeks after receipt of the signed Drawing for Approval. Please refer to our website for design ideas and samples. page 5 CREATING A GRAVE MARKER Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 6

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8 Marker Prices Grave-full and some ½ graves GRANITE BRONZE Single size (28 x 16 ) Black, Gray, Imperial Gray, Sunset Red...$ $1, Bahama Blue, Desert Rose, Himalayan, Serenity Red...$ Blue Pearl, Emerald Pearl... $ Mohagany... $1, Setting Fee... $ Companion (40 x 16 x 3 ) Black, Gray, Imperial Gray, Sunset Red... $1, $2, Bahama Blue, Desert Rose, Himalayan, Serenity Red... $1, Blue Pearl, Emerald Pearl... $1, Setting Fee... $ VA Match (24 x 12 )...$ $1, White Marble...$ Granite Base for bronze markers...$ (mandatory) Bronze markers include 3 lines, up to 26 characters, and 1 standard emblem. There is a shipping fee for all bronze markers of $ There is a layout fee of $50.00 for EVERY proof after the first layout. All granite markers include design and unlimited text. First layout fee is $50.00 but is applied to cost of marker if purchased at Ivy Lawn Memorial Park. CUSTOM ARTWORK...price upon request CHANGES TO EXISTING GRANITE MARKERS Adding inscriptions/dates...$ Re-highlighting...$ Set photo...$ (plus photo fees) IN ADDITION TO THE COST OF THE MARKER THE FOLLOWING FEES APPLY: Endowment care...$ Enhanced memorial account...$ (if burial was prior to July 2012) SERVICE FEES MAY APPLY: Coordinating design and production requirements... $ Re-setting (if existing marker is removed or replaced)...$ Administration fee: cancellation, complications, custom designs...$ Schedule marker setting...$ Schedule marker unveiling...$50.00 GRAVES MARKER PRICES page 7 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 8

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10 Cremation Gardens Graves SIZES: 8 x 12, 6 x 12, 20 x 10 GRANITE Garden Niches...$ Tribute graves (bronze and granite)...$2, (includes upright vase) Tribute inscription...$ Garden of Tranquility...$ Garden of Memories...$ Secret Garden...cost included in price of grave Garden of Rest - BRONZE ONLY...$ There is a shipping fee for all bronze markers of $ There is a layout fee of $25.00 for EVERY proof after the first layout CHANGES TO EXISTING GRANITE MARKERS Adding inscriptions/dates...$ Re-highlighting...$ Set photo...$ (plus photo fees) IN ADDITION TO THE COST OF THE MARKER THE FOLLOWING FEES APPLY: Endowment care...$ Setting fee...$ Enhanced memorial account...$ (if burial was prior to July 2012) CREMATION GARDENS GRAVES SERVICE FEES MAY APPLY: Coordinating design and production requirements... $ Re-setting (if existing marker is removed or replaced)...$ Administration fee: cancellation, complications, custom designs...$ Schedule marker setting...$ Schedule marker unveiling...$50.00 page 9 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 10

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12 Scattering Gardens and Memorial Walls Scattering Garden Engraving (limited in space, font, and layout...$ Memorial Wall Engraving (limited text, space, font choice, and layout)...$ Endowment Care...$ CHANGES TO EXISTING GRANITE MARKERS Adding inscriptions/dates...$ Re-highlighting...$ Set photo...$ (plus photo fees) page 11 SCATTERING GARDENS Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 12

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14 Baby Graves SIZES: 20 x 10 x 3 only GRANITE BRONZE Gray, Imperial Gray, Sunset Red...$ $1, Bahama Blue, Desert Rose, Himalayan, Serenity Red, Black...$ Blue Pearl, Emerald Pearl...$ Mahagony...$ BABY GRAVES There is a shipping fee for all bronze markers of $ There is a layout fee of $25.00 for EVERY proof after the first layout CHANGES TO EXISTING GRANITE MARKERS Adding inscriptions/dates...$ Re-highlighting...$ Set photo...$ (plus photo fees) IN ADDITION TO THE COST OF THE MARKER THE FOLLOWING FEES APPLY: Endowment care...$ Setting fee...$ Enhanced memorial account...$ (if burial was prior to July 2012) SERVICE FEES MAY APPLY: Coordinating design and production requirements... $ Re-setting (if existing marker is removed or replaced)...$ Administration fee: cancellation, complications, custom designs...$ Schedule marker setting...$ Schedule marker unveiling...$50.00 page 13 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 14

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16 UPRIGHT MONUMENTS The amount your family spends on a marker or monument is based on your budget. Factors that affect the price include the intricacy of the design, the material type, color and size. Ivy Lawn allows placement of an upright monument ONLY in designated areas. Prices vary. We will provide costs upon submission of size, design and color. One-time design fee required... $ CHANGES TO EXISTING GRANITE MARKERS Adding inscriptions/dates...$1, Re-highlighting...quote Set photo...quote (plus photo fees) IN ADDITION TO THE COST OF THE MARKER THE FOLLOWING ONE-TIME FEES APPLY: Endowment care...$2, Foundation for monument...$2, Setting fee...$2, Eternal memorial account...$ (if burial was prior to July 2012) SERVICE FEES MAY APPLY: Coordinating design and production requirements...$1, Administration fee: cancellation, complications, custom designs... $1, Schedule marker setting...$ Schedule marker unveiling...$50.00 UPRIGHT MONUMENTS page 15 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 16

17 PURCHASE OF FAMILY PLOTS & UPRIGHT MONUMENTS Because of the layout of Ivy Lawn Memorial Park, upright monuments are allowed ONLY in family plot sections which have been designated by the Board of Directors. They are not permitted in any other part of the cemetery. A family plot is a section of graves containing at least six (6) graves and up to twelve (12) graves, located in a designated monument area in the cemetery. The plots can contain full graves either single burial or double depth graves. The family plots will share one upright monument. One central memorial is allowed on a family plot defined as a plot containing at least 6 grave. The approved upright monument shall be set in the center (the easement) of the plot, unless otherwise requested and approved by Ivy Lawn. Both subbase and die must be granite. There are additional charges for setting the concrete base. There are different endowment care fees on an upright monument. Any upright monuments shall be of dimensions approved by our Board of Directors. Size and design must be submitted to the Ivy Lawn office for review and approval prior to purchase. EXCEPTION: The purchase of multiple plots signifies that there is the intention for multiple family members to be buried within a family plot. A family plot of at least 6 graves, by agreement of all family members, may be separated by separate deeds with a minimum of 2 graves to each purchaser. No assigning or transferring of burial rights to an outside party is allowed. Property may be returned ONLY to Ivy Lawn. Each purchaser/deedholder of less than 6 graves will NOT be entitled to place one individual upright monument in the easement section directly by their graves however they can place ONE upright monument that represents ALL separate Deedholders. Purchasers MUST agree that the monument size will be determined by Ivy Lawn Memorial Park. This limitation language will be added to every deed issued as part of this family plot purchase. Ivy lawn will provide the maximum monument size upon submission of the design by the Deedholder. Be prepared to provide Ivy Lawn Memorial Park with the identity of the designated person that the graves are intended for, and their relationship to the Deedholder. Pre need files can be set up at the time of purchase for each page 16 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 17

18 recipient and Authorizations can be signed immediately by the Deedholder. This will eliminate the need for the Deedholders signature at the time of need. Because the plots can be designated to specific family members at the time of purchase, complications are minimized. POLICY: DEEDHOLDER must sign a Marker Authorization allowing Ivy Lawn to place the upright monument. Refer to Ivy Lawn Rules and Regulations If marker is ordered from a source other than Ivy Lawn Memorial Park, the authorized agents MUST provide a release in writing, and the name of the producing company, a contact person, the company s complete address and a telephone number. Ivy Lawn requires producer to provide, in writing, size specification, inscription, and confirmation of the quality of the stone, prior to acceptance by Ivy Lawn. Ivy Lawn may contact the producing company to confirm Ivy Lawn s requirements. The completed work is subject to the approval of Ivy Lawn. Ivy Lawn staff must give written approval of blue print or sketch of the proposed memorial specifying size, inscription, quality of stone to the producer finishing the stone. Ivy Lawn reserves the right to reject any plan or design of any memorial which is, in its opinion, unsuited for the property on which it is to be placed or to the cemetery. All fees including but not limited to foundation fee, setting fee and endowment care fee must be paid prior to acceptance of a marker. These fees are to be paid directly to Ivy Lawn Memorial Park. No monument will be accepted by Ivy Lawn until Ivy Lawn receives full payment of the required fees. DELIVERY: Delivery must be arranged by the producer with the Ivy Lawn business office. Only qualified installers will be allowed to install and will sign Release of Liability. Ivy Lawn requires at least 48 hours notice prior to delivery. No delivery will be accepted after 3:00 p.m. There are NO weekend deliveries. Ivy Lawn will inspect the marker upon delivery. If damaged or unapproved, the product will not be accepted. It will be returned to sender. Ivy Lawn will notify the Deed holder or Authorizing Agent(s) if delivery/ acceptance is denied. Ivy Lawn will require a current ACORD certificate issued by the carrier/ agent of the marker company s insurance company that adds Ivy Lawn Memorial Park & Funeral Home as an additional insured on the company s policy page 17 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 18

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20 Crypt Plates Ivy Lawn allows only BRONZE crypt plates. Standard bronze colors include: Dark Brown, Light Brown & Black. For an additional cost Cherry, Blue and Green are also available. As a special order, we offer light & dark oxidized bronze for an additional 20% above our standard pricing. Throughout the bronze memorial industry, memorials are available in a variety of finish colors which are normally applied in the form of paint onto the surface of the bronze. This is the process we use on our standard memorials, as well. For an additional charge, we offer the oxidization process which colors the bronze to its natural dark brown finish. Bronze refinishing...$ Additional characters:...$5.00 each Additional emblems...$ each Hebrew lettering - up to 2 per character (no charge for 25 characters)...$5.00 Hebrew lettering - over 2 per character...$ each Asian lettering per character...$ each Arabic lettering per character...$ Personal signature...$ There is a shipping fee for all bronze markers of $ There is a layout fee of $25.00 for EVERY proof after the first layout Single crypt plate...$ Double crypt plate...$1, nd panel inscription...$ IN ADDITION TO THE COST OF THE CRYPT PLATE, THE FOLLOWING FEES ARE REQUIRED: Endowment care: single...$ double...$ Setting fee...$ Enhanced memorial account...$ (if burial was prior to July 2012) SERVICE FEES MAY APPLY: Coordinating design and production requirements... $ Re-setting (if existing marker is removed or replaced)...$ Administration fee: cancellation, complications, custom designs...$ Schedule marker setting...$ CRYPTS page 19 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 20

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22 Niche Plates Prices vary based on location. Chapel Niches BRONZE Single (3 x 5 )...$ (includes three lines, one standard emblem) Double plate for use as a single...$ Double with ½ blank (4 ¾ x 5 ½ ) included Three lines, one blank plate)...$ nd plate inscription (includes three lines)...$ Ivy Hall Bronze Fronts Each is 5 x 3, includes three lines...$ Loose Scrolls...$ Matching Scrolls...$ Veterans Scrolls...$ Shipping fee is $ for all bronze markers, scrolls, plates, etc. Rush fee is $ business days or less Rush fee is $ business days after drawing is approved. There is a layout fee of $25.00 for EVERY proof after the first layout. Custom Emblems Custom Emblems (require camera ready art) - price upon request Emblem designs can be cast on any memorial, space permitting For an additional charge a custom emblem can be supplied. Either camera ready or electronic artwork must be provided or art charges will apply. Foreign Characters...$30.00 each Bas Relief: Flex Design Memorials Bas Relief is a sculptured image cast in bronze. We require a minimum 5 x 7 photograph of the subject. An artist then sculpts the image using modeling clay. Once completed a digital photograph is supplied for the customer to approve. Once approved the image is cast in bronze. Price upon request. REQUIRED FEES - ALL MARKERS: Endowment care...$ Setting fee...$ Enhanced memorial account...$ (if burial was prior to July 2012) SERVICE FEES MAY APPLY: Coordinating design and production requirements... $ Re-setting (if existing marker is removed or replaced)...$ Administration fee: cancellation, complications, custom designs...$ Schedule marker setting...$ Schedule marker unveiling...$50.00 page 21 NICHES Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 22

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24 OPTIONAL PURCHASES PHOTOS First etched photo on black granite...no CHARGE Additional etched photo...$ each Black and white portrait medallions (choice of size and shape)...$ $ Color portrait medallions (choice of size and shape)...$ $ Photo cover...$ and up Emblems...$ and up Granite base for all bronze markers...$ and up CUSTOM EMBLEMS Custom Emblems (require camera ready art) - price upon request Re-highlighting...$ Set photo...$ (plus photo fees) OPTOINAL PURCHASES page 23 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 24

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26 Veteran s Markers A marker is supplied at no cost by the Veteran s Administration if provided with copy of Honorable Discharge or DD214 and a completed Application (see attached). This is the ONLY marker expense covered by the VA. The veteran marker choices are granite, marble or bronze. They are all the same size. The marker can include spouse if desired. If granite or marble is chosen, no base is required and it will be set exactly as it is made. If bronze is chosen a granite base is required. This is due to the material. The base will be 28 x 16 and solid granite. Ivy Lawn will set the bronze marker to the granite base. The finished bronze memorial will be mounted onto a polished granite base. Granite will be approximately 3 4 thick, polished top and rock sides. A 2 granite border around the bronze is standard (i.e. if the bronze memorial is 24 wide x 12 high, normally the granite is 28 wide x 16 high). All fees must be paid prior to ordering the marker. Cost of granite base...$ Additional fees that are required for all markers are: Endowment Care...$ Setting Fee...$ Enhanced Memorial Account...$ (if burial was prior to July 2012) Veteran Matching Bronze 24 x 12...$ (must be set on granite base, additional fees apply) Delivery charge...$ (required) VA Match includes: 3 lines of inscription up to 26 characters each, one emblem, one proof, includes design, names, and dates. page 25 VETERAN S MARKERS Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 26

27 GENERAL INFORMATION SHEET CLAIM FOR STANDARD GOVERNMENT HEADSTONE OR MARKER RESPONDENT BURDEN - Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. VA cannot conduct or sponsor a collection of information unless it has a valid OMB number. Your obligation to respond is voluntary, however, your response is required to obtain benefits. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the VA Clearance Officer (005R1B), 810 Vermont Avenue, NW, Washington, DC Please DO NOT send claims for benefits to this address. BENEFIT PROVIDED a. HEADSTONE OR MARKER Only for Veterans who died on or after November 1, Furnished for the grave of any eligible deceased Veteran. Will be provided for placement in private cemeteries regardless of whether or not the grave is already marked with a privately-purchased headstone or marker. Only for Veterans who died before November 1, Furnished for the UNMARKED GRAVE of any eligible deceased Veteran. The applicant must certify the grave is unmarked. For Veterans that served prior to World War I, a grave is considered marked when a headstone/marker displays the decedent's name only, or if the name was historically documented in a related document, such as by a number that is inscribed on a grave block and is recorded in a burial ledger. For service during and after World War I, a grave is considered marked if a headstone/marker displays the decedent's name and date of birth and/or death, even though the Veteran's military data is not shown. b. MEMORIAL HEADSTONE OR MARKER - Furnished for placement in a cemetery only to commemorate a deceased eligible Veteran whose remains have not been recovered or identified, were buried at sea, donated to science, or cremated and the remains scattered. May not be used as a memento. Check box in block 28 and explain in block 27. c. MEDALLION - Eligible Veterans may receive a Government-furnished headstone or marker, or a medallion, but not both. If requesting a medallion, please use VA Form M. WHO IS ELIGIBLE - Any deceased Veteran discharged under honorable conditions and any member of the Armed Forces of the United States who dies on active duty. A deceased Veteran discharged under conditions other than honorable may also be eligible. A copy of the deceased Veteran's discharge certificate (DD Form 214 or equivalent) or a copy of other official document(s) establishing qualifying military service must be attached. Do not send original documents; they will not be returned. Service after September 7, 1980, must be for a minimum of 24 months continuous active duty or be completed under special circumstances, e.g., death on active duty. Persons who have only limited active duty service for training while in the National Guard or Reserves are not eligible unless there are special circumstances, e.g., death while on active duty, or as a result of training. Reservists and National Guard members who, at time of death, were entitled to retired pay, or would have been entitled, but for being under the age of 60, are eligible; a copy of the Reserve Retirement Eligibility Benefits Letter must accompany the claim. Reservists called to active duty other than training and National Guard members who are Federalized and who serve for the period called are eligible. Service prior to World War I requires detailed documentation, e.g., muster rolls, extracts from State files, military or State organization where served, pension or land warrant, etc. WHO CAN APPLY - Federal regulation defines "applicant" as the decedent's Next-of-Kin (NOK); a person authorized in writing by the NOK; or a personal representative authorized in writing by the decedent. Written authorization must be included with claim. A notarized statement is not required. HOW TO SUBMIT A CLAIM FAX claims and supporting documents to IMPORTANT: If faxing more than one claim - fax each claim package (claim plus supporting documents) individually, i.e., disconnect the call and redial for each submission. MAIL claims to: Memorial Programs Service (41B) Department of Veterans Affairs 5109 Russell Road Quantico, VA A Government headstone or marker may be furnished only upon receipt of a fully completed and signed claim with required supporting documentation. SIGNATURES REQUIRED - The applicant signs in block 17; the person agreeing to accept delivery (consignee) in block 22, and the cemetery or other responsible official in block 24. If there is no official on duty at the cemetery, the signature of the person responsible for the property listed in block 21 is required. Entries of "None," "Not Applicable," or "NA" cannot be accepted. State Veterans' Cemeteries are not required to complete blocks 17, 18, 22 and 23. ASSISTANCE NEEDED - If assistance is needed to complete this claim, contact the nearest VA Regional Office, national cemetery, or a local veterans' organization. No fee should be paid in connection with the preparation of this claim. Use block 27 for any clarification or other information you wish to provide. Should you have questions when filling out this form, you may contact our Applicant Assistance Unit toll free at: , or via at mps.headstones@va.gov. TRANSPORTATION AND DELIVERY OF MARKER - The headstone or marker is shipped without charge to the consignee designated in block 19 of the claim. The delivery will not be made to a Post Office box. The consignee should be a business with full delivery address and telephone number. If the consignee is not a business explain fully in block 27. For delivery to a Rural Route address, you must include a daytime telephone number including area code in block 20. If you fail to include the required address and telephone number information, we cannot deliver the marker. The Government is not responsible for costs to install the headstone or marker in private cemeteries. CAUTION - To avoid delays in the production and delivery of the headstone or marker, please check carefully to be sure you have accurately furnished all required information before faxing or mailing the claim. If inaccurate information is furnished, it may result in an incorrectly inscribed headstone or marker. Headstones and markers furnished remain the property of the United States Government and may not be used for any purpose other than to be placed at an eligible individual's grave or in a memorial section within a cemetery. DETACH AND RETAIN THIS GENERAL INFORMATION SHEET FOR YOUR RECORDS. VA FORM MAY SUPERSEDES VA FORM , OCT 2012, WHICH WILL NOT BE USED. page 26 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 27

28 1. FOR VA USE ONLY Form approved, OMB No Respondent Burden: 15 minutes IMPORTANT: Please read the General Information Sheet before completing this form. Type or print clearly all information except for signatures. Illegible printing could result in an incorrect headstone or marker or delivery. Blocks outlined in bold are optional inscription items. Unless indicated otherwise all other blocks must be completed. MILITARY DISCHARGE DOCUMENTS OR RELATED SERVICE INFORMATION ARE REQUIRED. 2. NAME OF DECEASED TO BE INSCRIBED ON HEADSTONE OR MARKER (NO NICKNAMES OR TITLES PERMITTED) FIRST (Or Initial) MIDDLE (Or Initial) LAST SUFFIX 3. GRAVE IS: CURRENTLY MARKED (with privately purchased marker) NOT MARKED VETERAN'S SERVICE AND IDENTIFYING INFORMATION (Use numbers only, e.g., ) 4. VETERAN'S SOCIAL SECURITY NO. OR SERVICE NO. PERIODS OF ACTIVE MILITARY DUTY (For additional space use Block 27) 6A. DATE(S) ENTERED 6B. DATE(S) SEPARATED SSN: OR SVC. NO.: MONTH DAY YEAR MONTH DAY YEAR 5A. DATE OF BIRTH 5B. DATE OF DEATH MONTH DAY YEAR MONTH DAY YEAR 7. HIGHEST RANK ATTAINED (No pay grades) 8. BRANCH OF SERVICE (Check applicable box(es) - must be consistent with rank in Box 7) ARMY NAVY MARINE CORPS COAST GUARD AIR FORCE ARMY AIR FORCES MERCHANT MARINE OTHER (Specify) 9. VALOR OR PURPLE HEART AWARD(S) (Documentation must be provided) BRONZE MEDAL OF DST SVC NAVY AIR FORCE SILVER STAR PURPLE HONOR CROSS CROSS CROSS STAR MEDAL HEART OTHER (Specify) 10. WAR SERVICE (Check applicable box(es)) WORLD WAR II KOREA VIETNAM PERSIAN GULF OTHER (Specify) 11. TYPE OF HEADSTONE OR MARKER REQUESTED (Check one) 12. DESIRED EMBLEM OF BELIEF FLAT FLAT UPRIGHT FLAT BRONZE UPRIGHT EMBLEM NUMBER BRONZE GRANITE MARBLE MARBLE NICHE GRANITE NONE (Specify) (See reverse side of this form for available emblems) B G U F Z V 13A. NAME AND MAILING ADDRESS OF APPLICANT (No., Street, City, State, and ZIP Code) 13B. DAYTIME PHONE NO. OF APPLICANT 14. ADDRESS (Optional) 16. ARE YOU: NEXT OF KIN (Specify relationship) 15. FAX NO. (Optional) AUTHORIZED REPRESENTATIVE ON BEHALF OF DECEDENT (Include Written Authorization) AUTHORIZED REPRESENTATIVE ON BEHALF OF NEXT OF KIN (Include Written Authorization) CERTIFICATION: By signing below I certify the headstone or marker will be installed in the cemetery listed in block 21 at no expense to the Government and all information entered on this form is true and correct to the best of my knowledge. I also certify, to the best of my knowledge, that the decedent has never committed a Capital Crime or was never convicted of a sexual offense for which he or she was sentenced to a minimum of life imprisonment. 17. SIGNATURE OF APPLICANT 18. DATE (MM/DD/YYYY) 19. NAME AND DELIVERY ADDRESS OF BUSINESS (CONSIGNEE) THAT WILL ACCEPT PREPAID DELIVERY (No., Street, City, State, and ZIP Code); P.O. BOX IS NOT ACCEPTABLE 20. DAYTIME PHONE NO. (Include Area Code) 21. NAME AND ADDRESS OF CEMETERY WHERE GRAVE IS LOCATED (No., Street, City, State, and ZIP Code) CERTIFICATION: By signing below I agree to accept prepaid delivery of the headstone or marker. 22. PRINTED NAME AND SIGNATURE OF PERSON REPRESENTING BUSINESS (CONSIGNEE) NAMED IN BLOCK DATE (MM/DD/YYYY) CERTIFICATION: By signing below I certify the type of headstone or marker checked in block 11 is permitted in the cemetery named in block PRINTED NAME AND SIGNATURE OF CEMETERY OR OTHER RESPONSIBLE 25. DAYTIME PHONE NO. (Include Area Code) 26. DATE (MM/DD/YYYY) OFFICIAL 27. REMARKS (Additional inscription space will vary in size according to the type of marker) 28. CHECK BOX BELOW IF REMAINS ARE NOT BURIED AND EXPLAIN IN BLOCK SECTION/GRAVE NO. (State Cemetery Only) (e.g., buried at sea, remains scattered, etc.) REMAINS NOT BURIED VA FORM MAY CLAIM FOR STANDARD GOVERNMENT HEADSTONE OR MARKER page 27 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 28

29 ILLUSTRATIONS OF STANDARD GOVERNMENT HEADSTONES AND MARKERS UPRIGHT HEADSTONE WHITE MARBLE OR LIGHT GRAY GRANITE BRONZE NICHE FLAT MARKERS BRONZE This niche marker is 8-1/2 inches long, 5-1/2 inches wide, with 7/16 inch rise. Weight is approximately 3 pounds; mounting bolts and washers are furnished with the marker. Used for columbarium or mausoleum interment. Also provided to supplement a privately-purchased headstone or marker for eligible Veterans who died on or after November 1, 1990 and are buried in a private cemetery. This grave marker is 24 inches long, 12 inches wide, with 3/4 inch rise. Weight is approximately 18 pounds. Anchor bolts, nuts and washers for fastening to a base are furnished with the marker. The base is not furnished by the Government. LIGHT GRAY GRANITE OR WHITE MARBLE This headstone is 42 inches long, 13 inches wide and 4 inches thick. Weight is approximately 230 pounds. Variations may occur in stone color, and the marble may contain light to moderate veining. This grave marker is 24 inches long, 12 inches wide, and 4 inches thick. Weight is approximately 130 pounds. Variations may occur in stone color; the marble may contain light to moderate veining. NOTE: Civil War Era headstones - In addition to the headstone and markers pictured, two special styles of upright headstones are available for those who served with Union Forces during the Civil War or for those who served in the Spanish-American War, and another for those who served with the Confederate States of America during the Civil War. Requests for these special styles should be made in block 27 of the claim. It is necessary to submit detailed documentation that supports eligibility. Inscriptions on these headstone types are intentionally limited to assure historic accuracy. For example, only rank above 'Private' was historically authorized; emblems of belief and the words 'Civil War' are not provided. INSCRIPTION INFORMATION MEMORIAL HEADSTONES AND MARKERS (remains are not buried). The words "In Memory Of" are mandatory and precede the authorized inscription data. The words "In Memory Of" are only inscribed when remains are not available. MANDATORY ITEMS of inscription at Government expense are: Legal Name, Branch of Service, Year of Birth, Year of Death, and for State Veterans and National Cemeteries only, the section and grave number. Branches of Service are: U.S. Army (USA), U.S. Navy (USN), U.S. Air Force (USAF), U.S. Marine Corps (USMC), U.S. Coast Guard (USCG), U.S. Army Air Forces (USAAF), and other parent organizations authorized for certain periods of time; and special units such as Women's Army Auxiliary Corps (WAAC), Women's Air Force Service Pilots (WASP), U.S. Public Health Service (USPHS), and National Oceanic & Atmospheric Administration (NOAA). Different examples of inscription formats are illustrated above. More than one branch of service is permitted, subject to space availability. OPTIONAL ITEMS are identified on the claim in boxes with bold outlines. These items may be included at Government expense if desired. Optional items include month and day of birth in block 5A, month and day of death in block 5B, highest rank attained in block 7, awards in block 9, war service in block 10, and emblem of belief in block 12. War service includes active duty service during a recognized period of war and the individual does not have to serve in the actual place of war, e.g., Vietnam may be inscribed if the Veteran served during the Vietnam War period, even though the individual never served in the country. Supporting documentation must be included with the claim if you wish to include the highest rank and/or awards. ADDITIONAL ITEMS may be inscribed at Government expense if they are requested on the initial claim and space is available. Examples of additional items include appropriate terms of endearment, nicknames (in expressions such as "OUR BELOVED POPPY"), military or civilian credentials or accomplishments such as DOCTOR, REVEREND, etc., and special unit designations such as WOMEN'S ARMY CORPS, ARMY AIR CORPS, ARMY NURSE CORPS or SEABEES. All requests for additional inscription items should be stated in block 27, and are subject to VA approval. No graphics, emblems or pictures are permitted except available emblems of belief, the Medal of Honor, and the Southern Cross of Honor for Civil War Confederates. RESERVED SPACE for future inscriptions at private expense, such as spousal or dependent data, is allowed if requested in block 27 and if space is available. Only two lines of space may be reserved on flat markers due to space limitations. Reserved space is unnecessary on upright marble or granite headstones as the reverse side is available for future inscriptions. INCOMPLETE OR INACCURATE INFORMATION ON THE CLAIM MAY RESULT IN ITS RETURN TO THE CLAIMANT, A DELAY IN RECEIPT OF THE HEADSTONE OR MARKER, OR AN INCORRECT INSCRIPTION. page 28 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 29

30 Creative Burial and Memorial Options BENCHES PEDESTALS - CREMATION ESTATES Upon review and written approval by Ivy Lawn, benches, pedestals or cremation estates can be purchased and placed in the cemetery. You may be able to use existing burial property or you can purchase property specifically for placing a bench or pedestal or estate. Property purchases will be added to the price of the bench, pedestal or estate. Benches...starting at $7, Setting fee...$1,500 Offered in many different styles and colors. Some styles will accommodate urn burials. CREATIVE BURIAL OPTIONS Pedestals...starting at $7, Setting fee...$1,000 Offered in many different styles and colors Designed to accommodate urn burials. Niche Pedestals...starting at $10, Setting fee...$1,500 A Cremation Estate...$25, and up A cremation estate is a granite structure intended for the permanent placement of multiple urns. There are many styles and colors to choose from. They are designed for permanent inscriptions on both the front and rear of the structure. Emblems and other decorative choices can be inscribed on the estate for personalization. Prices vary based on design. BENCHES, PEDESTALS, ESTATES HAVE REQUIRED FEES: Initial engraving...$ (unlimited text) Additional engraving...$ (each appointment) Endowment care...$1, Foundations are required and prices will vary depending upon the specific bench. page 29 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 30

31 IVY LAWN MEMORIAL PARK POLICY FOR ABOVE GROUND PEDESTAL AND CREMATION BENCH Ivy Lawn Memorial Park strives to provide the most individualized and memorable moments to each and every person. In an effort to be creative, and provide loved ones with options that will last forever, we are excited to introduce urn burial options of pedestals and cremation benches. Pedestals are decorative inurnments. They are above the ground, granite monuments that are placed on a grave. There are choices of colors and granite tops that allow for personal preferences. Because the pedestals sit on top of a grave or other location, there are considerations that must be evaluated. Review of the proposed location is required and will be evaluated by the area of the placement location, proximity to other monuments in the area, and evaluation of potential maintenance issues. Required review by the grounds superintendent is necessary to verify placement will allow for safety of the pedestal and access for grounds maintenance. All locations must be approved by the general manager prior to purchase. Cremation Benches are decorative inurnments. A bench will allow for multiple inurnments in the bench. Benches are offered with color options, decorative options and the opportunity to personalize the bench with memorialization chosen by the purchaser. Every purchaser must understand and agree that the bench can be personalized for each purchaser but Ivy Lawn cannot guarantee that the bench will not be used by the general public. Any purchaser of a cremation bench must acknowledge that they are aware and accept that the bench is placed in the cemetery and will be available for anyone to sit on it. The benches are decorative monuments that can be placed in the cemetery if the location is approved. The bench sits on the top of graves/lots. The location to place the bench may be limited because of the size of the bench, and is dependent on review of the proposed location. Locations will be evaluated by the area of the placement, proximity to other monuments in the area, and evaluation of potential maintenance issues. Also,the direction of the bench placement must be in harmony with existing benches and monuments. The size of the bench will dictate the necessary grave layout to accommodate the bench. Required review by the grounds superintendent is necessary to verify placement will allow for safety of the pedestal and access for grounds maintenance. Every location must be approved by the general manager prior to purchase. page 30 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 31

32 GRAVE MARKER PURCHASED THROUGH AN OUTSIDE COMPANY The Rules and Regulations of Ivy Lawn Memorial Park have been revised. Effective immediately, the purchaser and deed holder of any grave must agree to accept and follow the current Rules and Regulations without exception. All purchasers are to understand and accept that some existing memorials may be exceptions to the current Rules and Regulations as these memorials were made by prior arrangements. This may allow for exceptions to what is stated in the current Rules and Regulations of Ivy Lawn. These exceptions do not imply that any exceptions to the current Rules and Regulations can or may be made in the future. The purchaser/deedholder/customer must accept and approve the marker, its condition, its design, and all details related to the marker PRIOR to signing the Authorization. By signing the Authorization to Order and Set Marker you will be authorizing us to accept the marker without ANY conditions. It is the purchaser s responsibility if there is damage to the marker or if the design elements are not as ordered. Ivy Lawn Memorial Park and Funeral Home will proceed with setting the marker if we have in our possession: 1. Signed Authorization from all authorities 2. Payment of all fees has been received The deed holder(s) and/or authorizing agent(s) must authorize agree and instruct Ivy Lawn Memorial Park to install the marker ordered. By signing the Authorization to Order and Set Marker you authorize us to accept the marker without ANY conditions. OUTSIDE COMPANY If there is a transfer or assignment of the grave, the same limitations apply. Please review the Ivy Lawn Memorial Park Rules and Regulations provided on pages included in this form. POLICY: If marker is ordered from a source other than Ivy Lawn Memorial Park, the authorized agents MUST provide the name of the producing company, a contact person, the company s complete address and a telephone number. Ivy Lawn may contact the producing company to confirm Ivy Lawn s requirements. page 31 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 32

33 The setting fee, endowment care fee and Eternal Memorial Account fee must be paid prior to acceptance of a marker. These fees are to be paid directly to Ivy Lawn Memorial Park. No marker will be accepted by Ivy Lawn until Ivy Lawn receives full payment of the required fees. Ivy Lawn requires producer to provide, in writing, size specification, inscription, and confirmation of the quality of the stone, prior to acceptance by Ivy Lawn. The completed work is subject to the approval of Ivy Lawn. Ivy Lawn will set an approved marker within 1 week of delivery. There are no scheduled settings. Customer to be aware that Ivy Lawn reserves the right to charge a professional fee of $50.00 if the producing company requires Ivy Lawn s assistance with designing, matching, or producing their sketch, blueprint or product. REQUIREMENTS: Deedholder must sign a Marker Authorization allowing Ivy Lawn to place the marker. Refer to Ivy Lawn Rules and Regulations The legal next-of-kin of all persons buried in the grave must sign a Marker Authorization form allowing Ivy Lawn to place the marker. Setting fee, Endowment Care fee and Eternal Memorial Account fee MUST be paid. Refer to Ivy Lawn Marker Price Sheet. Ivy Lawn staff must give written approval of blue print or sketch of the proposed memorial or marker, specifying size, inscription, quality of stone to the producer finishing the stone. Ivy Lawn reserves the right to reject any plan or design of any memorial which is, in its opinion, unsuited for the property on which it is to be placed or to the cemetery. DELIVERY: Delivery must be arranged by the producer with the Ivy Lawn business office. Ivy Lawn requires at least 48 hours notice prior to delivery. No delivery will be accepted after 3:00 p.m. There are NO weekend deliveries. The package must be clearly marked with decedent s name. Ivy Lawn will inspect the marker upon delivery. If damaged or unapproved, the product will not be accepted. It will be returned to sender. Ivy Lawn will notify the Deed holder or Authorizing Agent(s) if delivery/ acceptance is denied. Ivy Lawn will require a current ACORD certificate issued by the carrier/ agent of the marker company s insurance company that adds Ivy Lawn Memorial Park & Funeral Home as an additional insured on the company s policy. page 32 Ivy Lawn MarkerInfo Bklt x8.5 w/crops.indd 33