Practical

Forms & General Information

Below you will find the required forms to complete your arrangements. Please do not hesitate to call if you have questions: (248) 426-9200.

Printable & Downloadable Required Information Forms

Information form available online (below)

Online Information Form

  • Family Point of Contact

    Person Responsible for Arrangements & Payment

    0
  • First Name*
    1
  • M.I.*
    2
  • Last Name*
    3
  • Address*
    4
  • City*
    5
  • State*
    6
  • Zip Code*
    7
  • Home Phone*
    8
  • Cell Phone*
    9
  • Relationship to the Deceased*Husband, Wife, Son, Daughter, etc.
    10
  • 11
  • Deceased Vital Statistics for Death Certificate

    Information relating to the deceased

    12
  • Deceased's Name*
    13
  • M.I*
    14
  • Last Name*
    15
  • Name at Birth*If female, enter maiden name
    16
  • Sex*Male/Female
    17
  • Date of Birth*
    18
  • Date of Death*
    19
  • Social Security Number*
    20
  • Location of Death
    21
  • Address of Home, Name of Hospital, or Other Location*
    22
  • City*
    23
  • State*
    24
  • Zip Code*
    25
  • Home Address
    26
  • Home Address*
    27
  • City*
    28
  • State*
    29
  • Zip Code*
    30
  • Birthplace
    31
  • Birthplace City*
    32
  • State*
    33
  • Country*
    34
  • Personal Information
    35
  • Highest Education Grade Level or Degree Completed*
    36
  • Race*Caucasian, African American, etc.
    37
  • Ancestry*Irish, English, Mexican, African American, etc.
    38
  • Hispanic Origin*Choose One
    Yes
    No
    39
  • U.S. Military Veteran*Choose One
    Yes
    No
    40
  • Do You Have a Copy of the Discharge Papers?*If yes, please provide us a copy
    Yes
    No / Not Applicable
    41
  • While Working, the Deceased's Primary Occupation:*Please indicate job title or titles
    42
  • In What Industry?*Please indicate industry
    43
  • *Marital Status*
    Never Married
    Married
    Widowed
    Divorced
    44
  • Name of Surviving Spouse*If wife, please include maiden name
    45
  • Father's Name*
    46
  • Mother's Name & Maiden Name*
    47
  • 48
  • Informant

    Person Responsible for Providing Above Information

    49
  • First Name*
    50
  • M.I.*
    51
  • Last Name*
    52
  • Street Address*
    53
  • City*
    54
  • State*
    55
  • Zip Code*
    56
  • Relationship to Deceased*Husband, Wife, Son, Daughter, etc.
    57
  • 58
  • Method of Disposition

    59
  • Will This Be a Direct Cremation?*No Viewing, No Funeral Service
    Yes
    No
    60
  • If Yes, Please Select County in Which Death Took Place*
    Oakland/Wayne: $695
    Livingston, Macomb, Washtenaw: $795
    Not Applicable
    61
  • If No, Please Indicate When You Will Call*
    62
  • Number of Death Certificates Requested*Additional Clerk Fees Will Apply
    63
  • Please Select One*
    My loved one has passed and I WILL be calling you
    Pre-Arrangement: My loved one has not passed
    64
  • 65
  • Submission

    66
  • Download the Authorization and General Release Forms
    67
  • 68
  • 69
  • Required Forms*Please download and fill out
    I have downloaded the General Release and Authorization Forms
    70
  • By clicking submit I understand that I am responsible for any and all information provided and any errors made. I also understand that I must contact the funeral home directly for action to be taken.
    71
  • Pickup Location*
    Ann Arbor
    Shelby Township
    Farmington Hills
    Taylor
    72
  • 73
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