Pre Need Itemization Statement - PrePlan

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Firm NameAddress 1PrePlan Acct #Address 2PhoneCity/State/ZipBen. NameAddress 1Prearrangement Address 2PhoneCity/State/ZipE. Supervision (funeral director and staff)1. Supervision for visitation 2. Supervision for funeral service 3. Other supervisionA. Alternative Servicesspecify: 1. Direct Cremation2. Direct Burial ServicesF. Use of the Facilities1. Use of the facilities for visitation 2. Use of facilities for funeral service 3. Other use of facilitiesspecify: I. FUNERAL HOME CHARGES (Indicate N/A for items of service and/or merchandise that were declined and TBS for items of service and/or merchandise to be selected at a later date.)B. Transfer of remains to the funeral establishment, including personnel, equipment and vehiclePre Need Itemization Statement G. Livery1. a. Hearse orb. Alternative vehiclespecify: 2. Flower vehicle 3. Passenger car(s) Merchandise1. Casket or Alternative Containera.

Pre Need Itemization Statement Page 2. 13. I. Additional Services and Merchandise Selected. 14. (Describe and show price) 15. 1. Memorial Cards. …

  Testament, Needs, Pre need itemization statement, Itemization