This guide is intended for your personal use. You can print the guide and complete it at your convenience. Share your wishes with a family member, trusted friend, and your funeral director. If you do not want to review the guide with a family member, at least let someone know where it can be located in the event of your death.

Name: ___________________________________________

Date: ___________________________________________

This is who I want to handle my funeral:

Funeral Director: ___________________________________

Funeral Home: _____________________________________

Address: _________________________________________

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Notification: Please let all these people know of my death:

Spouse (telephone number) ___________________________

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Children (full names and telephone numbers) ______________

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Parents (names and telephone numbers) __________________

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Siblings (full names and telephone numbers) _______________

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Friends (full names and telephone numbers) _______________

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Business Associates (names and telephone numbers) 

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Place of Worship (include a telephone number) 

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I have indicated here topics I would like included in my newspaper obituary:

Spouse: __________________________________________

Date and Place of Marriage:  ___________________________

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Children: __________________________________________

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Other Survivors: ____________________________________

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My Address: _______________________________________

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Birth Date and Location: ______________________________

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Education (schools and degrees achieved): _________________

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Military Service: _____________________________________

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Occupation: ________________________________________

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Achievements/Awards: ________________________________

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Please also mention the following: ________________________

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The funeral director will need this when filling out my death certificate:

Date of Birth ________________________________________

Place of Birth  _______________________________________

Social Security Number ________________________________

Usual Occupation  ____________________________________

Kind of Business/Industry  ______________________________

Military Service  ______________________________________

Highest Level of Education Completed _____________________

Father’s Name (first, middle, and last) ______________________

Mother’s Name (first, middle, last and maiden) ________________

Place of disposition (name of cemetery, crematory or other place)

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Details of my funeral:

Speaker: ____________________________________________

Location of Funeral: ___________________________________

I prefer: _____ Flowers or _____ Tributes to (charity or organization)

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Favorite Music: _______________________________________

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Requested Readings: ___________________________________

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Burial Wardrobe and Jewelry: _____________________________

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Preferred Style/Material for:

Casket  ______________________________________________

Burial Vault ___________________________________________

Please ask these loved ones to be my pallbearers:

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Last Will and Testament:

Here is where you can find my will:  _________________________

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My Executor will be: ____________________________________

Phone:  ______________________________________________

Other Important Papers:

This list will help you locate documents necessary for settlement of my estate (birth certificate, marriage license, deeds, automobile titles, insurance papers, pension information, income tax records, banking records, bonds, securities, stock certificates, etc.)

Documents and Location: ________________________________

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Location of Safety Deposit Key:  ___________________________

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_____ Any needed organs or body parts

_____ No Donation

_____ Only those organs or body parts listed

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_____ I have a Living Will – Location is:

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