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A Death Has Occurred

We are very sorry for your loss and stand ready to assist you in your time of need.  If you have not already scheduled a meeting with us, please call us.

If you prefer, you are welcome to send us information using the form below.  We understand that you may not have access to all of the details below (or would prefer to provide in person).  You are welcome to fill out as much or as little as you prefer.  We will cover the remainder when we meet with you.


Arrangement Information

Not required but helpful
Not required but helpful
If nursing home, list nursing home name
Step-Parents, Adoptive Parents, etc

Step-parents, birth parents, adoptive parents, etc.

If a facility, list the facility not the address
If unknown, type unknown
If unknown, type unknown
e.g. Carpenter, Accountant. Do not use retired
e.g. - Industrial, Automotive, Steel, etc.
Enter names, locations and dates of employment

family

If predeceased, list dates of birth and death when known. Separate names by hitting the return key.
If predeceased, list dates of birth and death when known. Separate names by hitting the return key.
If predeceased, list dates of birth and death when known. Separate names by hitting the return key.
If predeceased, list dates of birth and death when known. Separate names by hitting the return key.

mILITARY RECORD 

CEMETERY INFORMATION

(If applicable)
(If applicable)
Separate names with a comma

If deceased passed at home


IN ORDER TO QUALIFY AS LEGAL NEXT OF KIN IN THIS SITUATION, A PERSON MUST BE OVER 18-YEARS-OLD. THE ORDER OF NEXT OF KIN IS LISTED BELOW.

1) Spouse

2) Children

3) Parents

4) Siblings

5) Authorized Guardian

6) Grandchildren

7) Great-grandchildren

8) Nieces and nephews

9) Grand-nieces and grand-nephews

10) Grandparents

11) Aunts and uncles

12) First cousins

13) Great-grandchildren of Grandparents

14) Second cousins

15) Fiduciary (a legally appointed trustee) 

prearranged?

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