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Palmer Mortuary
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Palmer Mortuary.
*Require fields

Person Completing this Form*:
Relationship*:
Email*:
 
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
Address:
(no P.O. Box)
City:
State:
Zip:
Date of Birth:
(mm/dd/yyyy)
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Degree:
Veteran: Yes No
Military Branch:
Dates of Service:
Occupation:
Spouse's Full Name:
(Wife's maiden name, if applicable)
Religious Affiliation/Congregation:
 
Family Member Information

Family Member #1

 
Funeral Arrangement Details
Person in charge of arrangements:
 
Place of service or gathering:
If Other, please specify:

 

Preference for final disposition:
If Other, please specify:
Cemetery:
Disposition of cremated body:
 

In the space provided below, please share any information that would be helpful in creating a meaningful service. (ie. favorite hobbies, places, music selections, poems, scripture, etc.)

Any final thoughts that should be shared?

 

Do you wish to be contacted to discuss the details
of these arrangements, cost or payment options? Yes No

If yes, how should we contact you:
Phone Number:

If no, we will keep this information on file until you or your surviving family requests it.

  security code
Enter Security Code:

 

NOTE:
Texas law requires sellers of prepaid funeral contracts to hold a permit issued by the Texas Department of Banking. For additional information regarding prepaid funeral contracts, go to the website located at: www.prepaidfunerals.texas.gov.

Diana Lynn Rivera Memorial
Died: 12/3/2017
Santiago Hernandez, Jr.
Born: 10/9/1938
Died: 12/1/2017
Leroy Long
Born: 1/25/1927
Died: 11/29/2017
Frances Vasquez
Born: 2/26/1936
Died: 11/27/2017
Bertha Miranda
Born: 4/23/1942
Died: 11/25/2017
Rubie Luckey
Born: 1/20/1922
Died: 11/23/2017
Magdalena Garcia
Born: 2/2/1962
Died: 11/23/2017
Gilberto Sanchez Jr.
Born: 11/22/1970
Died: 11/20/2017
Andrew Ramon
Born: 4/8/1977
Died: 11/15/2017

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Palmer Mortuary | 1116 N. Austin Street | Seguin, TX 78155 | 830-379-9430
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