Survivor Information

From this page you can submit information for our records. This does not commit you to use our services or form any type of contract with us. This is used strictly as a convenience for you. You may also fill in this form and print it out for your records without sending it to us. This form requests the information that will help a Funeral Director complete the survivors section of the obituary.

Your Full Name
Which funeral home would like to have keep this record?
Spouse Name
Your children - Please list oldest to youngest and use this format: Relationship, First name, spouses first name, last name and city of residence. i.e., Son: John & Susie Doe of Grand Rapids, MI
Please list your parents if they are still living. Use the same format as above.
Please list your surviving brothers and sisters. Use the same format as above.
Number of grandchildren
Number of great grandchildren
Number of Great Great Grandchildren
Who would you like to act as casketbearers?

Please type this word as it is shown into this text box

Don't forget to fill out the Services information page, the vitals information page and the obituary information page.