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Platinum-Bronze Burial Package At-Need
Thank You for selecting Edwards Funeral Service to serve your family. Our burial package includes everything needed from the funeral home, here is a listing of "Outside Expenses" that need to be considered. The Funeral Home can add these to the Funeral Statement and take care of these items for you, or you can choose to handle each item directly.
Outside Cash Advance items to consider
Please select the additional items that you will need from our Funeral Director or wish our Funeral Director to assist you with.
Certified Death Certificates
*
$0 No Death Certificate Needed
$25 (1) Death Certificate
$50 (2) Death Certificates
$75 (3) Death Certificates
$100 (4) Death Certificates
$125 (5) Death Certificates
$150 (6) Death Certificates
Please select the number of Certified Death Certificates that you would like the Funeral Home to purchase for you.
Casket Floral Spray
*
$0 No Casket Spray desired
$150 Basic Carnations
$200 Medium Carnations
$250 Large Carnations
$200 Basic Roses
$250 Medium Roses
$300 Large Roses
Please select a Floral price point for the Spray that sits on top of the casket if desired
Hair Dresser / Barber
*
$0 Not Needed
$75 Hairdresser
$50 Barber Services
Clergy Honorarium
*
$
Dollars
.
Cents
Please enter an amount that you want the Funeral Director to provide to the Clergy from the family
Name of Cemetery
*
Please let us know the name of the Cemetery where the burial will occur
Opening & Closing
*
$
Dollars
.
Cents
This is the fee that the cemetery will charge to open & close the grave. Enter 0 if this has already been paid
Limo
*
$0 - No Limo Requested
$300 - 1 Limo
$600 - 2 Limo's
Please let us know if you desire for the Funeral Director to schedule Limo transportation for the Funeral.
Newspaper Obit
*
$
Dollars
.
Cents
Enter a dollar figure that you would like to allocate to publishing the obit in the Newspaper
Purchaser Information:
Please provide your information as purchaser and legal next-of-kin
Name
*
First
Middle
Last
Suffix
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Please enter the mailing address of the Legal Next of Kin
Email
*
Please enter your Email address
Phone
*
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###
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Please enter your phone number so that one of our Funeral Director's can get in touch with you if needed.
Relationship
*
What is the Legal Next of Kin's relationship to the decedent
Decedent's Information
This information will be used to generate the Death Certificate for the Doctor's signature
Decedent Name
*
Prefix
First
Middle
Last
Suffix
Please enter the complete name for the Deceased
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Please enter the last residential address of the deceased.
Date of Birth
*
MM
/
DD
/
YYYY
Please enter the date of BIRTH for the decedent
Place of Birth
*
City, State - Decedent's Place of Birth
Date of Death
*
MM
/
DD
/
YYYY
Please enter the date of DEATH for the decedent
Social Security Number
*
Please enter the Social Security Number for the decedent
Sex
*
Male
Female
Please enter the gender of the decedent
Race
*
White
Black or Africian American
American Indian
Asian Indian
Chinese
Flipino
Japanese
Korean
Vietnamese
Other Asian
Native Hawaiian
Samoan
Other Pacific Islander
Unknown
Not Obtainable
Refused
Other
Please select the Race of the Decedent
Martial Status
*
Please select
Divorced (Not Remarried)
Married
Married, but Separated
Single, Never Married
Not Obtainable
Unknown
Widowed
Please list decedent's martial status at the time of their death.
Spouse Name
First
Middle
Last
If Married, Please enter the name of the Spouse
Maiden Name
If Married, Please enter the maiden name for the wife
Father's Name
*
Prefix
First
Middle
Last
Suffix
Please enter the decedent's fathers name.
Unknown is a valid choice if name is not known
Mother's Name
*
Prefix
First
Middle
Last
Suffix
Please enter the decedent's mothers name
Unknown is a valid choice if name is not known
Mother's Maiden Name
*
Please enter mother's maiden name
Unknown is a valid choice if name is not known
Education
*
Unknown
Less Then 8th Grade
8-12, No diploma
H.S. Diploma or G.E.D.
Associates Degree
Bachlor's Degree
Master's Degree
P.H.D., Professional Degree
Enter the decedent's highest level of education attained
Usual Occupation
*
Please describe the type of work decedent performed the majority of their working years
Unknown is a valid option if Occupation is not known.
Industry
*
Please describe the Industry of occupation
Unknown is a valid option if not known.
Veteran
*
Yes, Honorable Discharge
Yes, Other type of discharge
No
Was the decedent ever in the U.S. Military?
DD214 Available
Yes
No
Do you have a legible copy of the Military Discharge document (Routinely called a DD214)
DD214 Upload
Please upload a copy of the DD214 Discharge if available
Branch of Service
Date of Entry
MM
/
DD
/
YYYY
Date of entry into the Military
Date of Discharge
MM
/
DD
/
YYYY
Date of discharge from active duty military