Pre-Arrangements

What effect would an unexpected death have on your family?

Who will be handling your arrangements? Do you plan to leave this burden to your parents, spouse, or children? What is preplanning a funeral? Answer: It is recording your preferences regarding funeral arrangements, securing necessary biological information and selection of merchandise before death occurs. You do not have to prepay anything to preplan a funeral, but if you decide to prepay, the price of your selection will be locked in at today’s prices and you will not have to pay more when prices increase.

Personal Information

First Name:
Middle Name:
Last Name:
Maiden Name(if applicable):


Mailing Address:
City:
State:
Zip:


Date of Birth:
Birthplace:
SS#:

Marriage Information:

Date of Marriage:

If Widowed:
Date of Spouse Death:

City of Spouse Death:

If former Marriage:
Date of Termination:
Former Spouse Name:

Military Information

Armed Forder Serial Number:
Dates of Service:
Rank:
Commendations:

Educational Information

1st School Information:
2nd School Information:
3rd School Information:

Occupational Information

Employer:
Employer Address:
Employer City and State:
Date of Retirement:

Parent's Information

Father's Name:
Father's Birthplace:
Mother's Maiden Name:
Mother's Birthplace:

Location of Important Documents

Will is located:
Durable Power of Attorney for Health Care is located:
Organ Donation Papers are located:
Birth Certificate is located:
Marriage License is located:
Citizenship Papers are located:
Legal Name Chnage Papers are located:
Deeds and Mortgage Papers are located:
Pension Certificates are located:
Auto Titles are located:
Bank Notes, Trust Papers are located:
Stock and Bond Certificates: are located:
Income Tax Records are located:
Check Book is located:
Diplomas and Degrees are located:
Inventory of HH Goods is located:
Medical Records are located:
Social Security Card is located:
Unpaid Bills are located:
Safety Deposit Box is located:
Safety Deposit Box Key is located:

Funeral Information

Funeral Director:
Funeral Home:
Clergy Person:
Clergy Contact Info:

Pallbearers:
1.
2.
3.
4.
5.
6.

Special Requests:

Casket:
Burial Vault:
Clothing:
Cemetery:
Cemetery Location:
Section number:
Block Number:
Location of Deed:

Special Instructions: