Funeral Information Form
This form is provided to consolidate the information necessary when answering questions at an arrangement meeting. Please print the form; all of this information will be needed when documents are completed with your funeral director. If there are any questions please contact us.
Please Print and Complete # of Certified Copies __________
Name________________________________________________________________________
First Middle Last Suffix
Gender _______ Marital Status ________Spouses Name(wife’s Maiden) __________________________
Date of Birth______________________ Place of Birth_________________________________
City and State
Social Security Number _______________________ Veteran __________________DD214 copy needed
Residence ________________________________________________________________________
Street Address apartment or unit #
________________________________________________________________________________
City State Zip Code
Father_________________________________ Mother ___________________________________
First and Last First and Maiden Name
Highest Education Level _____________Hispanic _________________ Race ___________________
Occupation _______________________________Type of Industry ___________________________
Method of Disposition ____________________ Cemetery Name ______________________________
Cemetery Address ______________________________________ Cemetery Phone _______________
Informant Name____________________________________________ Relationship ______________
First Middle Last
Home Address __________________________________________________________________
Street City State Zip Code
Home Phone ________________ Cell Phone ___________________ Work Phone __________________
Email address_______________________________________________________________________
Additional Contacts ____________________________________________________________________
Name Cell Home
Address_______________________________________________________________________
Additional Contacts ____________________________________________________________________
Name Cell Home
Address_______________________________________________________________________
X___________________________________________________________Date___________________
The information above is correct – where information was in error I have corrected and initialed. It is important that this information is correct; it will be used to complete all the forms by your funeral director.
Since 1986, Cremations and Funerals Affordably Priced continues to be the affordable alternative to traditional funeral providers, serving Chicago and the Northwest suburbs of Illinois. Offering a simplified selection process and a convenient and beautiful new facility, Cremations and Funerals Priced Affordable typically will cost significantly less than most families expect. Families that compare realize what a value Affordable Inexpensive Funerals and Cremations, Cremations and Funerals offer to families; at an Affordable Price.