Prearrangements,Cemetery and Funeral Preplanning

Pre Arrangements

One can make prearrangements, personally or for someone else,
in many ways. The prearrangements can be "Informational Only",
or can be "Prepaid".

"Informational Only" pre-planning consists of recording one's preferences for:

Obituary Information
Chapel, Church Or Graveside Service
Viewing
Casket Or Cremation Container
Final Disposition (Burial Or Cremation)
Cemetery Burial Vault Or Urn
Memorial Donations
Music, Religious, Or Poetry Selections For A Funeral Service

"Prepaid" prearrangements consist of the above information and the placement of financial resources to be used at the time of death. These resources can be placed in a funeral trust account or life insurance policy. By doing so, the cost of the prepaid service is guaranteed until the time of death, at no additional cost.

Personal Information

Name
(First MI Last):

Marital Status: Social Security#:

Date of Birth: Place Of Birth:

Address:

City: State:

County: Zip:

Phone: E-mail:

Spouse's Name: Spouse's Maiden Name:

Place of
Marriage: Date of Marriage:

Father's Name: Mother's Name:

Mother's Maiden Name:

Work/Education History

Education(0-12): College 1-5+:

Occupation:

Business: Company:

Military Record

Branch of Service: Serial Number:

Date Enlisted: Rank At Discharge:

Date Discharged: Discharge On File At:

Copy of Discharge Papers: Yes No

Name Of Wars:

Person in Charge:

Address:

Phone:

Insurance Information:

Funeral Service Request

Place Of Service:

Funeral Home:

Address: Phone:

Place of Visitation:

Religious Denomination:

Place Of Worship:

Lodge / Union:

Person in Charge of Final Arrangements:

Special Instructions

Flower Preference:

Music

Casket Bearers (6):

Jewelry:

Glasses:

Clothing:

Other:

Disposition Request

I Prefer:

Cemetery:

Address: Phone:

Section:

I have made a last will and testament: Yes No

Location:

Other Instructions

Memorials/Donations To Charity

Please select one of the options below

Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file

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