Purpose of the Designation of Death Benefit Beneficiary Form

The Tribe pays up to $6,000 for funeral and burial costs. The funeral and burial costs will be provided regardless if there is a Designation of Death Benefit Beneficiary form on file or not.

 There is a $1,000 benefit that is paid directly to the Designated Death Benefit Beneficiary that is not used for the funeral and burial costs. There is no restriction on how the Beneficiary spends this money. There is no “default beneficiary” such as a spouse or parents.

 The form is used for the Tribal member or their guardian to designate the person they want to receive the Death Benefit beneficiary amount.

 It is recommended a copy of the Form is kept with other legal documents such as the Last Will & Testament and a copy given to the Beneficiaries with a copy of this guide.

 The named Beneficiary can choose to designate another person to make the funeral arrangements on their behalf, however, payment will be sent to the named Beneficiary.

Death Benefit Beneficiary Form Information

Tribal Member may:

  • Choose anyone over the age of 18.
  • Choose a Tribal member or non-Tribal.
  • Choose a family member or non-family.
  • List up to 3 beneficiaries. If adding additional beneficiary(ies), See the Designated of Death Benefit Beneficiary form for details.
  • Update this Form with the Enrollment Department as often as needed.
  • Contact the Enrollment Department to inquire who their own Death Benefit Beneficiaries are on file.

 Tribal Member must:

  • Have the Designation of Death Benefit Beneficiary Form notarized to ensure the Tribal member/their guardian completed the Form.
  • Submit the original Form in person or by mail to the Enrollment Department.
  • Submit an updated Form if beneficiary’s contact information changes by completing an updated Form, obtain notary then submit the original to the Enrollment Department.

What Happens

Upon receiving notice of the passing of a Tribal member, the staff will contact the first named Beneficiary if not the one notifying staff.

 Tribal Staff cannot share the name or contact information of the Beneficiary with anyone other than the Beneficiary. However, you may provide name and contact information for Enrollment to disclose to others so they may send condolences for the family.

 The Beneficiary/family can use Death Benefits for:

  • Funeral attendant;
  • Casket;
  • Burial plot;
  • Flowers;
  • Headstone/marker;
  • Vault;
  • Facility use; AND/OR
  • Any costs associated with the funeral services.

 The Beneficiary/family may purchase a Tribal blanket and/or casket from the tribe. Pick up in Siletz or be charged for delivery within the Tribe’s 11 county service area. These costs will be deducted from the benefit amount.

 Once funeral arrangements have been made, the Beneficiary/family contacts the Enrollment staff with information to publically post the Celebration of Life/Funeral Services to all tribal offices and website.

 Upon receipt of the original long form Death Certificate and the Funeral Home invoice/contract for services payment will be processed up to 3 weeks. Note the Death Certificate will not be returned.

What to do Checklist

  • Obtain Funeral Home information Name of facility, name and phone number of contact person.
  • Contact the Enrollment Department at 541-444-8258 with the following information:
    • The Tribal Member’s name
    • The Funeral Home information
    • If it is okay to announce services
    • If you want to purchase a Tribal casket
    • If you want to purchase a Tribal blanket for burial

 Paul Washington Cemetery

  • Contact the Culture Department for plot location at 541-444-8208
  • Contact Public Works for Gravesite Prep 541-351-0135

If Tribal Member is a Veteran

  • Contact the Veterans Coordinator at 541-444-8330

If you want to use facilities

  • For Tribal Community Center contact Facilities Clerk at 541-444-8367
  • For Dance House contact the Culture Department at 541-444-8208

For Potluck Assistance

  • Contact Programs at 541-444-8220