Funeral Instructions

I Hereby Request the following actions be taken upon my death:

I prefer my services to be held:
I would prefer as clergy:
I request the following music:
My funeral director is:
I have viewed caskets and would prefer:
Outer enclosure desired:
Clothing preferred:
I request: Burial Entombment Cremation
Location:
My executor/executrix is:
Please provide a contact email:
Other Special Instructions:


VITAL STATISTICAL RECORDS

Full Name:
Street Address:
City & State:
Telephone:
Marital Status:
Spouse:
Birthplace:
Father's Name:
His Birthplace:
Mother's Name:
Her Birthplace:
Length of Residence Here:
Coming From:
Usual Occupation:
Employer:
Social Security Number:
Veteran:
Religion:
Church:
List Clubs and Organizations:
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