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Cremation Atneed information form


If your family has just lost a loved one and are in immediate need, please accept our sincerest condolences. Whether it was expected or not, losing a loved one is never easy. Rest assured, our staff of caring and knowledgeable Pennsylvania licensed funeral directors will be here to assist you every step of the way. We make it a priority to assist you to the best of our ability and ensure that we make the arrangement process easy and straightforward.

To begin moving forward with the cremation arrangement process, it is very important that we collect specific information immediately. Please take a few moments to fill out the form provided below. Please note that we understand that you may have information for every section below. We simply ask that you provide us with as much information as possible, so we can begin moving forward with the completion of legal documents and arranging the service.

Upon completion of the form, you will be contacted shortly thereafter by a member of our staff if you haven't spoken to someone already. We understand how difficult this experience can be and want you to know that we will be here to assist and support you every step of the way. If you have any questions or concerns, please do not hesitate to contact us.If your family has just lost a loved one and are in immediate need, please accept our sincerest condolences. Whether it was expected or not, losing a loved one is never easy. Rest assured, our staff of caring and knowledgeable funeral directors will be here to assist you every step of the way. We make it a priority to assist you to the best of our ability and ensure that we make the arrangement process easy and straightforward.


At Need

Deceased Information

Include Jr or Sr here is applicable
If nursing home, list nursing home name
Please list name even if deceased
Please list name, even if deceased
Select One
Select One
Select One
Select One
Other spouses, dates, etc
If unknown, type unknown
Step-parents, birth parents, adoptive parents, etc.
If a facility, list the facility and not the address
If unknown, type unknown
If unknown, type unknown
Specify Here
Specify Here
DO NOT USE RETIRED
e.g - Industrial, Automotive, Steel, etc.

Military Record of the deceased

It's okay if there are multiple people in photo. We can crop it

Personal INformation of Person legally responsible for disposition

In order to qualify as legal next-of-kin in this situation, the person must be over 18 years old. The order of kinship 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

PREARRANGED?

If you can't or don't want to upload a payment method; an emailed invoice will follow for your to pay on our secure Quickbooks (Intuit) Website.  Cash is also accepted by appointment only.


selections

Need to Select a number. You can put zero and order later
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