Funeral Planning Guide

Funeral Planning Guide

Step 1 of 4

Vital Statistics Record
Name*
Prefix First Middle Last Suffix
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Enter Email Confirm Email
Birthdate*
MM slash DD slash YYYY
Birthplace*
Father's Name*
Mother's Maiden Name*
Marital Status*
Marriage Details
Married To
Date
Place
Death Date
Previous Marriage
Married To
Date
Place
Death Date

Immediate Family
Relationship, Name, City & State
Preceded by
Local emergency contacts to be notified at need
Emergency Contact Name
First Last
Emergency Contact Address
Street Address City State ZIP Code
Emergency Contact Phone
Additional Emergency Contact Name
First Last
Additional Emergency Contact Address
Street Address City State ZIP Code
Additional Emergency Contact Phone