At Need Form

The Information Form Below Must Be Filled Out for the Deceased Person.


      
(******* No More Than 3 People May Come To Make Any Arrangements For Any Services! ******* )
 (At Need Information and Help Form ) 
PLEASE USE THIS FORM BELOW: to provide us with as much detail as you can. Please provide all phone numbers of person to contact before you meet with our staff.
 *** CREMATION INFORMATION: *** 
 Anyone requesting cremation please note that the Surviving Spouse must sign the Authorization to Cremate Form.
If the spouse is deceased then all surviving Children must sign the Authorization to Cremate Form.
If it is a child then both parents must sign the Authorization to Cremate Form.
If no family members then the Legal Representative or Representatives must sign the Authorization to Cremate Form. Proof of Representation must be give at time of authorization.

    For more information on who must sign Authorization to Cremate please call our office at :     
 301-253-2138
                                  ****(The Family must obtain a Clergy for any services they request.) *****

***** ( PLEASE SEE REMINDER BELOW )!!! *****

      NOTE; *** Please do not make or plan any funeral arrangements for any services until you have talked to your funeral director. We will help you plan the Dates and Times for your Services when you meet with us. *********. 
                                   ( PLEASE NOTE;  SUNDAY FUNERAL SERVICES ARE NOT AVAILABLE FOR ANYONE. )

  PLEASE USE FORM BELOW 
PLEASE READ AND FILL IN ALL THE INFORMATION BOXES BELOW.
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*** Please Note: Full Payment For Our Services, Will Be Due On The Day you make your Arrangements ***
 *** We No Longer Take or Do Insurance Assignments As Payment ***

******* (All Information Must Be Correct On This Form) *****
 * The Funeral Will Not and Can Not Be Held Responsible For Any Mistakes *

***** NOTE: Please Bring Deceased Persons ID with you at time of your Arrangements:*****
Acceptable ID :
**  Drivers License, or Real ID,  Social Security Card, or Birth Certificate,  **
Start Form Below
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At Need Information Form for the Deceased. START HERE

Personal Information:       ** All Information Must Be Correct On This Form **  

 * The Funeral Home Will Not and Can Not Be Held Responsible For Any Mistakes Made On This From *  ** ID for the Deceased Will Be Required When You Come Into Our Office**

* Full Legal Name & Address & Age of deceased must be on this form**
**
SS number must be on this form. Proof will be needed when you come in.
Proof may be needed at time of arrangements
Place Your Name, Phone # and Address in the Box Above

Work/Education History

Military Record

Funeral Service Request

**The Funeral Home Does Not Provide Clergy for any Services**
We Accept: Checks, Cash, VISA, MASTERCARD, & DISCOVER CARD. , No Insurance Assignments,

Disposition Request

The Funeral Home Does Not Provide Pallbearers.
(if applicable)
(if applicable)
(if applicable)

Summary Details

Please use the area above to enter the names of children

Thank you, Please click the GREEN submit button when done with the Security Question Above ! >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

DO NOT USE THE FORM BELOW THIS LINE

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STOP! STOP! STOP! 

DO NOT USE FORM BELOW

STOP HERE !!!!!!!!











At Need Details

Personal Information Form

Please use the area above to enter the names of siblings, children and grandchildren.

Work/Education History

Military Record

Funeral Service Request

(if applicable)
(if applicable)
(if applicable)

Summary Details

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