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Nebraska Department of Veterans' Affairs

Headstone Inscription Request

Nebraska Veterans Cemetery at Alliance uses the government issued upright marble headstone on casket and cremation graves. It is 24-26 inches tall above ground, 13 inches wide, 4 inches thick and weighs approximately 230 pounds. Variations may occur in stone color and the marble may contain light to moderate veining. This is the same style of headstone that is used at Arlington National Cemetery.

How To Complete The Form:

A MAXIMUM Of 11 lines are available for inscription. Lines 1-4 have a MAXIMUM length of 13 characters; lines 5-11 have a MAXIMUM length of 15 characters. When completing the request, do not write outside of the boxes.

Please provide the following information in order: (Items In Bold Are Mandatory)

  • Emblem of Belief
    Enter the corresponding 2-digit number on Line 1. See a list of Authorized Emblems of Belief.
  • Legal Name (First Name, Middle Name or Initial, Last Name)
    Nicknames are not permitted on these lines. Maiden names are allowed for the non-veteran, if space is available.
  • Rank (DO NOT use pay grade)
    Use the rank as listed on the DD Form 214 or Discharge papers (i.e. CPL, A1C, SSGT, etc.)
  • Branch (i.e. US Army, US Navy, US Air Force, etc.)
  • War Period
    Allowed if the veteran was active duty during the war period. The war can be listed even if the individual never served in combat.
  • Date of Birth
  • Date of Death
  • Medals (Documentation must be provided)
    See the Authorized Awards page for medals that are allowed to be inscribed on the headstone.
  • Term of Endearment
    You may use one of the examples listed on our Terms of Endearment page; you may also request words or phrases that have special meaning to your family or the decendent. This is the place to include a nickname or list a unit, ship, or specific designation if desired.

A cemetery representative will gladly provide assistance with questions you have
about this form, eligibility, or cemetery services.

Examples of Completed Forms:

Click on an image to enlarge it

Complete form example 1 Completed form example 2

How To Apply:

The Headstone Inscription Request form is in pdf format; you can print for completion or fill in on the computer for print or electronic submission. Once completed, submit the form and appropriate documentation by mail, in person to the Veterans Cemetery Administration Building, or by email to