Georgia National Guard

Request Form

Please fill out the information to the best of your ability. Missing or unknown data can be collected at an alternate time. visit the FAQ page for further information and contacts.

The Honored Deceased

Deceased Name (Last First middle):

Deceased Rank:

Deceased SSN: Numbers only

Deceased Branch:

Other branch? please see contacts or the FAQ page.

Type Of Honors:

Proof of Service (DD form 214):

Funeral Information

Date: mm/dd/yyyy

Time:

Name of the Location:

Location Address:

City:

State:

Please refer the the Resources Page for funerals outside Georgia.

Zip Code:

County:

Service:

Point of Contact

Your Name and Name of Funeral Home:

Your Relationship to the Deceased:

Your Email:

Your Phone Number: