OBITUARIES GRIEF ASSISTANCE PLAN AHEAD CONTACT US HOME WHO WE ARE LOCATIONS REMEMBER THEIR STORY LIVE PASSIONATELY
Information about person completing the form:
First Name:
Last Name:
E-mail:
Street Address:
City:
State:
Zip Code:
Phone:

Person(s) To Finalize Arrangements At Time Of Death:
Check here and skip this section if this information is the same as person filling out this form
 
Full Name:
Street Address:
City:
State:
Zip Code:
Phone:

Vital Information about the person you are planning for:
I am Planning for:
First Name:
Middle Name:
Last Name:
Sex:
Marital Status:
Social Security#:
Date of Birth:
Place Of Birth:
Spouse's Full Name:
Spouse's Maiden Name:
Place of Marriage:
Date of Marriage:
Father's Full Name:
Mother's Name:
Mother's Maiden Name:
Funeral Service Information:
Place Of Service:
Name of Funeral Home:
Address:
Phone:
Place of Visitation:
I Prefer The Funeral Service To Be:
Viewing For Family:
Viewing For Friends:
Religious Denomination:
Place Of Worship:
Lodge / Union:

Military Records:
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:
Disposition Options:
I Prefer:
Section:

Last Will and Testament
I have made a last will and testament:   Yes     No
Location of Will:
Other Information & Special Instructions
Please list any other instruction or information you would like us to have:

Memorials & Charities
Please list any Memorials or Donations to Charity that you would like:


Options
Please select from the options below:
Send information about Advance Plans
Contact me to set an appointment
Please keep my information on file
 

French Funerals - Cremations       PO Box 25063       Albuquerque, NM 87125-0063        1-505-843-6333            info@remembertheirstory.com