Funeral Arrangement Checklist

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FUNERAL ARRANGEMENT CHECKLIST

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Immediate Need Form

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Information of the Deceased

Name of Deceased

Home Address

Telephone Number

Place of Death

Date of Death*

Social Security Number

Date of Birth

Zip/Postcode*

Last Name:

First Name*

Street*

State/Province*

Primary Phone Number*

Best Time to Reach Via Phone*

Age

Physician Name and Address

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Veteran's Information

Date and Place of Enlistment

Date and Place of Discharge

Serial Number

Rank

Veteran's Claim Number

Branch of Service and Organization Served With

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Informant Information

Informant Name

Relationship to Deceased

Home Address

Phone Number

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Funeral Information

Church Membership

Date and Day of Service

Time

Place of Funeral

New Field:

Cemetery

Grave Location

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A Year of Grief Support

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