Funeral Home in Flemington New Jersey (NJ)

Holcombe-Fisher Funeral Home
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Funeral Home Flemington, NJ
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Obituaries, Flemington NJ
Funeral Preplanning, Flemington

This form is intended to help gather information that we need in the event of a death. It is also intended to help clarify your wishes and desires. Please note that filling out this form and sending it to us does not obligate you financially or otherwise. We encourage you, after filling out this form, to speak with us so we can go over your information. We will be happy to call you at your convenience.

YOUR INFORMATION
Today's Date:
First:
Middle:
Last:
I am planning for my:
E-mail:
Daytime Phone:
Evening Phone:
Fax (If available):
INFORMATION ON PERSON PLANNING FOR
Be sure to use their Full Legal Name
First Name:
Middle Name:
Last Name:
Sex:
Marital Status
Education Level:
Date of Birth:
Place of Birth:
Street Address:
Mailing Address:
City:
State:
Zip Code:
Is Home Address Inside City Limits:
Spouse's Full Name:
Spouse's Maiden Name:
Mother's Name:
Mother's Maiden Name:
Father's Name:
MILITARY SERVICE
Service Branch:
Serial Number:
Place Enlisted:
Date Enlisted:
Place Discharged:
Date Discharged:
VA Claim
or File #:
FUNERAL PREFERENCES
Place of Service:
Name of Cemetery:
City:
State:
Grave or Niche Location:
Religious Denomination:
Church Affiliation:
Name:
Viewing For Family:
Viewing For Friends:
I Prefer:
For the family selecting cremation, what
disposition of the remains would you prefer:
Musical Selections To Be Played: 1.
2.
3.
4.
Musical Selections To Be Sung: 1.
2.
3.
4.
Favorite Bible Passages:
Favorite Literature Or Poems:
Favorite Flower(s):
Favorite Flower Color:
FINAL DISPOSITION
Preference For Final Disposition Is:
OBITUARY INFORMATION
Survivor Name Relationship City State
PERSON(s) TO FINALIZE ARRANGEMENTS AT TIME OF DEATH
Name:
Relationship:
Address:
Daytime Phone:
Evening Phone:
Second Contact
Name:
Relationship:
Address:
Daytime Phone:
Evening Phone:
ORGANIZATIONS/MEMBERSHIPS

I wish for Memorial Donations to be made to:

OTHER INFO/CONTACTS/SPECIAL REQUESTS

Please Call Me
Tell Me How To Pre-Pay Expenses
Keep Information On File
Send Me a Copy of My Information

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