Deceased Veteran and Surviving Family Member or Relative
Submitter First Name
Submitter Last Name
If the bill is passed, a ceremony will be in Washington, D.C.
Veterans First Name
Honorably at any time during the period beginning July 26, 1941, and ending December 31, 1946; (2) in an active-duty status under the command of the United States Armed Forces in Far East; and (3)(A) within the Philippine Commonwealth Army, the Philippine Scouts, the Philippine Constabulary, Recognized Guerrilla units, the New Philippine Scouts, the First Filipino Infantry Regiment, the Second Filipino Infantry Battalion (Separate), or the First Reconnaissance Battalion;
Veterans Last Name
Branch of Service
New Philippines Scouts
Philippines Commonwealth Army
1st Filipino Infantry Battalion
2nd Filipino Infantry Regiment
1st Reconnaissance Battalion
Unit Specific Name or Specific
(Batangas FAIT, or 57th In Regt PS)
Regions are located on slide 10-11:
Region1 - CT, ME, MA, NJ, PA, NY, RI, NH
Region2 - DE, DC, MD, VA, WV
Region3 - IL, MN, MI, NE, WI
Region4 - IN, IA, KY, MI, OH
Region5 - AL, FL, GA, MS, NC, SC, TN, PR, VI
Region6 - CO, KS, MT, ND, SD, WY
Region7 - TX, LA, NM, AR, OK
Region8 - AK, ID, OR, WA
Region9 - CA
Region10 - NE, AZ UT
Region11 - HI, GU, AS, MP
Submitted name to National?
Say “No” until your Region Chair has confirmed it is submitted
A copy of the bill is located here:
Have you emailed or mailed evidence to
or 1802 Ridgewood, Houston, TX 77006?
Evidence can be a photo in uniform, orders, service number
Please describe evidence of service for named veteran.
Upload any attachments as evidence of service based on the Filipino WWII Congressional Gold Medal requirements.
Privacy Statement: By completing this form you consent that information you provide will be used for the purpose of requesting a copy of the Congressional Gold Medal for your requested family member. If you are successful you will be contacted on the next steps.
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Send me a copy of my responses.
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