Funeral Planning Guide Funeral Planning Guide Step 1 of 4 25% Vital Statistics RecordName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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*MarriedDivorcedSingleWidowedMarriage DetailsMarried ToDatePlaceDeath DatePrevious MarriageMarried ToDatePlaceDeath Date Personal HistoryOccupationEmployerPosition HeldHow LongRetired Yes No YearResident Cities, YearEducationLodges, Memberships, Church & Public Office HeldMilitaryWarBranchRate or Rank at DischargeEnlistment Date and PlaceDischarge Date and PlaceService NumberCounty RecordedPhotographPhotograph for obituary Yes No Upload photographMax. file size: 50 MB. Immediate FamilyRelationship, Name, City & StatePreceded byLocal emergency contacts to be notified at needEmergency Contact Name First Last Emergency Contact Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency Contact PhoneAdditional Emergency Contact Name First Last Additional Emergency Contact Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Additional Emergency Contact Phone Funeral Service Instructions and InformationType of ServiceTraditional Funeral ServiceCremation ServiceType of Casket (if applicable)Paragon MahoganyPembroke CherryAegan BronzeGreyson S/SEmbassy CherryPieta MapleBarkley OakPearson Cherry VeneerSacrament Maple VeneerGolden Rose S/SSilver Sapphire S/STapestry Rose S/SWoodbridge PecanCameron Oak VeneerGolden Midnight 18 ga.Mayfair 18 ga.Woodhaven Pecan VeneerJ37 Topaz 18 ga.Fairfield HardwoodPrimrose 18 ga.Opal 18 ga.Auburn Sunset 18 ga.Burnished Silver 18 ga.Sierra 18 ga.R59 Coretta 20 ga.Heirloom Pewter 20 ga.Q02 Earthtone 20 ga.ES16 ClothType of Urn (if applicable)Cashmere Gray UrnEbony Capsule UrnAlpine White Cultured MarbleMeadow Green Cultured Marble UrnRiverstone Gray Cultured Marble UrnAshen PewterBlue DelphiaChestnut BronzeCrimson DelphiaMagnolia Pink CloisonneMinimum OakMonroe OakSolaris Hardwood Picture Frame UrnSolaris Keepsake UrnType of Burial Vault (if applicable)Triune BronzeTriune CooperTriune StainlessVeteran StainlessCameo Rose StainlessVenetianContinentalMonticelloSaluteGravelinerCemeteryCemetery LocationSectionLotSpaceMarker InstalledAny other final arrangements prepaid?Special instructionsFuneral HomeChurchGravesidePrayer ServiceRosaryVisitationRemarksClergyOrganistVocalist(s)Music SelectionsFavorite Bible Passages, Poetry, Quotations and Verses, etc.Flower RequestsClothing (new, present, color)Decisions on clothing, jewelry to be made by?JewelryRingsEarringsOtherParticipating Organizations (Fraternal/Military Rites)Pallbearers (Name, City, State)Memorial ContributionsOther Special RequestsSpecial Instructions
