Submit Vital Information

Cremation

Submit Vital Information For Cremation

From the information you provide on this form, we will create the necessary cremation arrangement documents.

Submit Vital Information - Cremation

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Decedent's Vital Information

First Name

Middle Name

Last Name

Suffix

Gender

Date of Birth

Birthplace

Social Security

Maiden Name

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Decedent's Residence

Street

City

State/Province

ZIP/Postcode

County

Is Residence Inside City Limits?

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Marital Status

Spouse's Full Name

Spouse's Maiden Name

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Optional Info

Is the decedent a military veteran?

Race

Highest Education

Main Occupation

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Decedent's Parents

Father's Full Name

Mother's Full Name

Mother's Maiden Name

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Person Making Arrangements

Full Name

Relationship to the Person Above

Email Address

Cell Phone

Home Phone

Street

City

State/Province

ZIP/Postcode

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If Known

Date of Death

Place of Death

How Many Death Certificates Do You Need?

Would you like us to create an Online Tribute Page on our website?

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Cremation Decisions

Is there a pacemaker present?

After the cremation

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Urn Selection

After the cremation, in what type of container would you like your loved one's cremated remains returned? (choose one)

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Service / Ceremony

Will there be a ceremony before or after the cremation?

Final Resting Place: