Pay.gov - NCA Central Office Donation Form

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Please enable cookies before continuing.</p> </div> </div> </div> </div> <script type="text/javascript"> var postLink = function( action, showLoadingScreen ) { $("#linkPostForm").attr("action", action); $("#linkPostForm").submit(); //show modal loading screen, if requested: if(showLoadingScreen===true) blurScreen(); } </script> <form id="linkPostForm" class="margin-bottom-0" action="/public/home" method="POST"> <div> <input type="hidden" name="formToken" value="dbdeb901-1699-4627-9f4a-8fc621a64c55" /> </div></form> <div id="mainContent" class="mainContent" role="main"> <div class="grid-container"> <h2 id="pageHeader" class="pageHeader"> NCA Central Office Donation Form </h2> <div> <div> <ul class="multi-steps margin-bottom-4"> <li class="is-active" aria-label="active step Before You Begin" tabindex="2" id="formNavStep0"> Before You Begin </li> <li tabindex="2" id="formNavStep1"> Complete Agency Form </li> <li tabindex="2" id="formNavStep2"> Enter Payment Info </li> <li tabindex="2" id="formNavStep3"> Review & Submit </li> <li tabindex="2" id="formNavStep4"> Confirmation </li> </ul> </div> <div class="clear"></div> <div class="margin-top-4"> <h4 class="margin-0"> About this form </h4> <p id="formDescriptionContainer"> Please use this form to submit donations to NCA Central Office, Washington D.C. </p> </div> <div class="margin-top-4"> <p id="paymentInstructionsContainer"> <p>For donations of $10,000 and greater, please contact NCA at <a class="usa-link--external" href="mailto:cemNCADonations@va.gov" target="_blank" rel="nofollow noopener noreferrer">cemNCADonations@va.gov</a>. <br> <br> <br><a class="usa-link--external" href="https://www.cem.va.gov/videos.asp#sacred" target="_blank" rel="nofollow noopener noreferrer">Click here to read more about NCA</a><br> <br><a class="usa-link--external" href="https://www.cem.va.gov/find-cemetery/index.asp" target="_blank" rel="nofollow noopener noreferrer">Find a Cemetery</a><br> </p> </p> </div> <div class="margin-top-2"> <h4 class="margin-0"> Accepted Payment Methods: </h4> <ul id="payment-methods" class="usa-list margin-top-2"> <li id=ACHDebitListItem>Bank account (ACH)</li> <li id=AmazonListItem>Amazon account</li> <li id=PayPalListItem>PayPal account</li> <li id=PlasticCardListItem>Debit or credit card</li> </ul> </div> <div class="margin-top-2"> <h4 class="margin-0"> With an account you can: </h4> <ul id="account-options" class="usa-list margin-top-2"> <li id=ListItem1>See the payments you made since you created an account. </li> <li id=ListItem2>Store payment information so you don't have to re-enter it. </li> <li id=ListItem3>Copy a form you already submitted the next time you need to make a payment. </li> <li id=ListItem4>Set up automatic recurring payments. </li> </ul> <p id="loginPromptContainer"> <strong> To take advantage of these benefits, you can <a href="/public/form/login/552130654" id="loginPromptLoginButton" class="usa-link" tabindex="2" onclick="gas('send', 'event', 'Button', 'Click', 'step0-Sign-In')" > Sign In</a> . 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The information you will enter will remain private. <a href="/public/about-us/privacy-and-security" id="treasuryButton" tabindex="2" > Please review our privacy policy </a> for more information. </p> </div> <form id="continueToForm" action="/public/form/route/101" method="POST"> <div id='recaptcha' class="g-recaptcha" data-sitekey="6LcMCKQlAAAAAG4BgQHCwELNAsaEEOabCJ_rFdxt" data-callback="captchaCallback" data-size="invisible"> </div> <div> <input type="hidden" name="formToken" value="dbdeb901-1699-4627-9f4a-8fc621a64c55" /> </div></form> <div class="usa-accordion usa-accordion--bordered margin-top-4"> <h2 class="usa-accordion__heading"> <button id="helpAccordion" class="usa-accordion__button" aria-expanded="false" tabindex="2" aria-controls="inline-help-accordion"> We're here to help! </button> </h2> <div id="inline-help-accordion" class="usa-accordion__content usa-prose"> <div class="grid-container padding-x-0"> <div class="grid-row"> <div class="grid-col-12 desktop:grid-col-fill margin-y-1"> <div for="helpContactName"> <span class="text-bold">Contact:</span> </div> <div id="helpContactName">NCA Donations</div> </div> <div class="grid-col-12 desktop:grid-col-fill margin-y-1"> <div for="helpContactEmail"> <span class="text-bold">Email:</span> </div> <div id="helpContactEmail"> <a tabindex="2" class="usa-link" href="mailto:cemNCADonations@va.gov"> Click to email</a> </div> </div> </div> </div> </div> </div> <div id="viewpdf" class="display-none" aria-hidden="true"></div> <div id="hiddenForm" class="display-none" aria-hidden="true"></div> </div>  <div id="signInModal" class="modal" aria-hidden="true"> <div class="modal-dialog"> <div class="modal-header clearfix"> <span class="float-left text-white text-bold">Form requires sign in</span> <span class="float-right"> <a id="XButton" href="javascript:void(0);" title="Close" class="text-white text-bold text-no-underline" onclick="closeModal();" role="button" tabindex="1">X</a> </span> </div> <div class="modal-body" role="alert" aria-live="assertive"> <p class="text-bold margin-bottom-4"> You must be signed in to submit this form. </p> <p class="margin-0"> If you already have an account, </p> <p class="margin-top-0 margin-bottom-2"> <a href="/public/form/login/552130654" tabindex="2" id="requiredLoginButton" class="usa-link text-bold"> Sign In </a> . 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} </script> <script type="text/javascript"> const FILES = [ '/public/resources/js/vendor/formio/formio.full.min.js', '/public/resources/js/vendor/formio/components/premium.min.js', '/public/resources/js/vendor/formio/components/uswds.min.js', '/public/resources/js/vendor/formio/components/vpat.min.js' ]; $(function() { $("a#continueButton.dialogButton").on("click", () => { openModal(); }); $("button#continueButton").on('click', () => { return captchaSubmit($("#continueToForm"), true); }); loadJsFiles(FILES) .then(() => fetchFormDefinition()) .then((formDefinition) => { setDefaultValue(formDefinition, 'agencyFormId', 552130654); return formDefinition; }) .then((formDefinition) => createHiddenForm(formDefinition)) .catch(() => { // if any of the above fails create PDF without endpoint submission data. const formElement = createViewPdfFormElement({ method: 'GET', action: '/public/form/preview/pdf/101' }); $('#viewpdf').append(formElement); // setup preview button click event to trigger form submit. $("#previewFormButton").on('click', (event) => { event.preventDefault(); formElement.submit(); }).removeAttr("disabled"); // remove disabled attr so the user can click the button after the DOM has loaded. }); }); const fetchFormDefinition = () => { return $.ajax({ url: '/public/api/ws/form/definition/552130654', type: 'GET', dataType: 'json', contentType: 'application/json;charset=utf-8' }); } const setDefaultValue = (formDefinition, componentName, value) => { const component = FormioUtils.getComponent(formDefinition.components, componentName); if (component) { component.defaultValue = value; } } // create a hidden form.io form to populate the form with endpoint submission data. const createHiddenForm = (formDefinition) => { Formio.license = true; Formio.use(premium); Formio.use(uswds); Formio.use(vpat.default); return Formio.createForm(document.getElementById('hiddenForm'), formDefinition).then((form) => { // setup form event to create pdf. form.on('viewPdf', () => { const formElement = createViewPdfFormElement({ method: 'POST', action: '/public/form/data/preview/pdf/101', submission: form.submission }); $('#viewpdf').append(formElement); formElement.submit().remove(); }); // setup preview button click event to trigger form event. $("#previewFormButton").on('click', (event) => { event.preventDefault(); form.emit('viewPdf', form.submission); }).removeAttr("disabled"); // remove disabled attr so the user can click the button after the form has loaded. }); } // submission of this form will trigger PDF creation. const createViewPdfFormElement = (settings) => { const formElement = $('<form />', { id: 'viewpdfform', action: settings.action, method: settings.method, target: '_blank' }).append( $('<input/>', {name: 'formToken', type: 'text', value: $("meta[name=_csrf]").attr("content")}) ); if (settings.submission) { formElement.append($('<input/>', {name: 'formSubmission', type: 'text', value: JSON.stringify(settings.submission)})); } return formElement.append($('<input/>', {type: 'submit'})); } // javascript files must be loaded one by one, in order. an error will short circuit the forEach and not move on to the next file. const loadJsFiles = (files) => { var result = Promise.resolve(); files.forEach(url => { result = result.then(() => loadJsFile(url)); }); return result; } // dynamically load javascript files. returns a promise that will 'resolve' or 'reject' based on if the file was loaded or not. const loadJsFile = (url) => { return new Promise((resolve, reject) => { // adding the script tag to the head const head = document.getElementsByTagName('head')[0]; const script = document.createElement("script"); script.type = "text/javascript"; script.src = url; script.async = true; script.defer = true; // then bind the event to the resolve function // there are several events for cross browser compatibility script.onreadystatechange = resolve; script.onload = resolve; script.onerror = reject; // fire the loading head.appendChild(script); }); } </script> </div> <div> <footer class="usa-footer"> <div class="primary-grid-container usa-footer__return-to-top font-sans-3xs"> <a href="#" tabindex="2">Return to top</a> </div> <div class="usa-footer__primary-section bg-accent-warm-lighter font-sans-3xs"> <nav class="primary-grid-container usa-footer__nav" aria-label="Footer navigation"> <ul class="grid-row grid-gap"> <li class="mobile-lg:grid-col-4 desktop:grid-col-auto usa-footer__primary-content"> <a tabindex="2" class="usa-footer__primary-link text-left" href="/public/about-us/accessibility-statement" id="accessibility-footer-link"> Accessibility Policy </a> </li> <li class="mobile-lg:grid-col-4 desktop:grid-col-auto usa-footer__primary-content"> <a class="usa-footer__primary-link" tabindex="2" href="/public/about-us/privacy-and-security" id="privacy-footer-link"> Privacy and Security Policy </a> </li> <li class="mobile-lg:grid-col-4 desktop:grid-col-auto usa-footer__primary-content"> <a class="usa-footer__primary-link" tabindex="2" href="/public/about-us/notices-and-agreements" id="notices-footer-link"> Notices and Agreements </a> </li> <li class="mobile-lg:grid-col-4 desktop:grid-col-auto usa-footer__primary-content"> <a class="usa-footer__primary-link" tabindex="2" href="/public/about-us/for-agencies" id="for-agencies-footer-link"> For Agencies </a> </li> <li class="mobile-lg:grid-col-4 desktop:grid-col-auto usa-footer__primary-content"> <a class="usa-footer__primary-link " href="/public/help/troubleshooting" id="troubleshooting-footer-link" tabindex="2">*</a> </li> <li class="mobile-lg:grid-col-4 desktop:grid-col-fill usa-footer__primary-content"> <a class="usa-footer__primary-link usa-link--external" id="feedback-footer-link" href="#confirmExternalRedirectModal" aria-label="Give feedback" aria-controls="confirmExternalRedirectModal" onclick="preventOutsideTabbing()" tabindex="2" data-open-modal> Feedback </a> </li> </ul> </nav> </div>  <div class="bg-primary-darker text-white"> <div class="primary-grid-container font-sans-3xs"> <div class="grid-row"> <div class="grid-col-12 mobile-lg:grid-col-6 margin-bottom-1"> <div class="display-flex flex-row flex-align-center padding-top-2 padding-right-2"> <div class="margin-right-2"> <img class="usa-footer__logo-img" width="42" height="42" src="/public/resources/images/eftps/bureau-of-the-fiscal-service-Seal.png" alt="fiscal service seal" /> </div> <div> <span class="usa-footer__logo-heading text-bold">Pay.gov<br> </span> <span>Pay.gov is a program of the U.S. Department of the Treasury, Bureau of the Fiscal Service</span> </div> </div> </div> <div class="grid-col-fill grid-col-8 mobile-lg:grid-col-6 padding-top-2"> <ul class="usa-list text-align usa-list--unstyled"> <li class="text-bold font-body-sm"> <a class="text-white text-no-underline hover:text-underline" tabindex="2" href="/public/help/pay-gov-support" id="pay-gov-support-footer-link"> Pay.gov Support </a> </li> </ul> </div> </div> <div class="grid-col-fill tablet:grid-col font-sans-3xs text-justify padding-y-3"> <p class="usa-paragraph">WARNING WARNING WARNING</p> <p class="usa-paragraph measure-none">You have accessed a U.S. Government information system, which includes (1) this computer, (2) this network, (3) all computers connected to this network, and (4) all devices and storage media attached to this network or to a computer on this network. U.S. Government information systems are provided for the processing of official U.S. Government information only. Unauthorized or improper use of this information system is prohibited and may subject you to disciplinary action, as well as civil and criminal penalties. All data contained on U.S. Government information systems is owned by the U.S. Government and may, for the purpose of protecting the rights and property of the U.S. Government, be monitored, intercepted, recorded, read, searched, copied, or captured in any manner and disclosed or used for any lawful government purpose at any time. THERE IS NO RIGHT TO PRIVACY IN THIS SYSTEM. System personnel may give to law enforcement officials any potential evidence of crime found on U.S. Government information systems. USE OF THIS SYSTEM BY ANY USER, AUTHORIZED OR UNAUTHORIZED, CONSTITUTES YOUR UNDERSTANDING AND CONSENT TO THIS MONITORING, INTERCEPTION, RECORDING, READING, COPYING, OR CAPTURING AND DISCLOSURE.</p> <p class="usa-paragraph measure-none">Note: This system may contain Sensitive But Unclassified (SBU) data that requires specific data privacy handling.</p> </div> <img id="keepAliveImg" alt="Keep Alive Placeholder" width="1" height="1" src="/public/resources/images/80percentOpacityBkg.png?"/> </div> </div> <div id="confirmExternalRedirectModal" class="usa-modal" aria-labelledby="confirmExternalRedirectionNotice" aria-describedby="confirmExternalRedirectCloseReminder"> <div class="usa-modal__content"> <div class="usa-modal__main"> <h2 class="usa-modal__heading" id="confirmExternalRedirectionNotice"> You are about to leave Pay.gov and visit an external site. 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