What are the Survivor benefits? Survivor compensation, insurance benefits, etc.? Retirement Pay and other Benefits Non-Government Organizations or companies; i.e. Private Companies, Non-profits, etc. Item Veteran Spouse, if applicable Has the veteran or spouse work (Check one) one) □Yes □No □Yes □No for and become eligible to receive retirement pay or survivor benefits from this type organization? Is the veteran or spouse eligible to (Check one) (Check one) □Yes □No □Yes □No receive retirement pay and/or benefits from this type organizations? If yes, name of the (Check one) (Check one) □Yes □No □Yes □No organization and if yes, plan or company name Name of the organization, contact information for the organization or the benefit’s coordinator. Type of benefits received (retirement pay and the amount), survivor benefits, health insurance, etc.? and location of employment $_________ month $_________ month Current retirement pay ($/month) Is there a Survivor Benefit package (Check one) (Check one) □Yes □No □Yes □No for the surviving spouse? If yes, how much per month?
What are the Survivor benefits? Survivor compensation, insurance benefits, etc.? Retirement Pay and other Benefits Non-Government Organizations or companies; i.e. Private Companies, Non-profits, etc. Item Veteran Spouse, if applicable Has the veteran or spouse work for and become eligible to receive retirement pay or survivor benefits from this type organization? □Yes □No (Check one) □Yes □No one) Is the veteran or spouse eligible to receive retirement pay and/or benefits from this type organizations? □Yes □No (Check one) □Yes □No (Check one) If yes, name of the organization and if yes, plan or company name □Yes □No (Check one) □Yes □No (Check one) Name of the organization, contact information for the organization or the benefit’s coordinator. Type of benefits received (retirement pay and the amount), survivor benefits, health insurance, etc.? and location of employment Current retirement pay ($/month) $_________ month $_________ month Is there a Survivor Benefit package for the surviving spouse? If yes, how much per month? □Yes □No (Check one) □Yes □No (Check one)
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