Kansas Adjutant General's Department
Kansas Adjutant General's Department
Kansas National Guard Military Funeral Honors
Kansas Adjutant General’s Department
2800 SW Topeka Blvd.
Topeka KS 66611

Rod Moyer 785-274-1520
SGT Churchill 785-274-1208
Fax # 785-274-1687

This form is intended to be used only to request military funeral honors for an eligible veteran. Honors request information can be called in, faxed, or e-mailed to the address listed above. It is not mandatory, but helpful if you would please attach or forward an eligibility document or a DD Form 214 for the veteran.

PART ONE: Funeral Home Information

PART TWO: Information – Deceased Veteran

PART THREE: Type of Honors Requested by the Family

PART FOUR: Funeral Honors Location
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If you do not hear from us within 24 hours, or in a case of a short notification, confirm the coordination with us.


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