Final arrangements

To relieve relatives and friends from burdens at the time of my passing,

I,   [print name]  __________________________________  would like:

Name of mortuary ______________

Autopsy [usually mandatory]    Yes __________ No ________

Embalmed  Yes ______________ No _________

Body to be viewed by family _______   by friends __________

Type of casket  [not nec. when cremated in some states] ____________

Obituary in paper [withOUT address] ____________

Service: Yes _________ No _______ Priv ____ Public _____

Informal _______ Formal ______ By whom ______

Where _________ Passages to be read ________

Disposition of remains:

Donate to medical school ____

Buried in which cemetery ____ Type of vault __________

Cremated and put in wall ___ ground _____ on family

property ______ or scattered _____ at/over _______

Vital Statistics – for death certificate

Birth date and place ______________

Full name of father and place of birth ________________

Maiden name of mother and place of birth _______________

Social Security no. ______________________

Will updated on [date] ___________    It’s located at _________

Name and location of:

Cemetery plots  ___________________

Life insurance co _________________ individual ____ group _____

Health insurance  _____________       Homeowners insurance  ________________

Car insurance _______________ Trusts  _______________________

Powers of Attorney _______________ Combinations to safes   ______________________

Partnerships ____________________ Contracts  _____________________

Checking accounts ________________ Savings accounts   _____________________

Credit cards ____________________ CD’s  ___________________

Stocks _________________ Bonds _______________________

Mutual funds _____________________IRA   _______________   Keogh   _____________

Deeds ___________________   Mortgage cos. _____________________

Birth cert. _____________________ Lawyer _______________

Accountants  ________________________  Brokers  ______________________

Banks ____________________________ Safety deposit box  __________________

Valuables __________________________ Military discharge  ____________________

Other ________________________________________________

Date _______ Signature ______________________________________