Signed in as:
filler@godaddy.com
Signed in as:
filler@godaddy.com
This form is required by the funeral home. It contains all the vital information needed to process your arrangements, securing regulation permit, death certificate, identify your legal next of kin and emergency contact information.
The Decedent's info section is the person who is preplanning. The Informant section is for the legal next of kin.
For your convenience, we recommend to use a desktop computer to download the form and complete it in preparation for your appointment.
Being that your funeral plan is funded through a funeral life policy, personal identification information will be required, such as ID verification for name, address, date of birth, and social security number.
You can also think of one or two people you would like to assign as beneficiaries. Typically they would be the ones meeting with the funeral home for your final arrangements.
Acceptable forms of payment can be either credit cards or EFT (Electronic Transfer Fund). You have the choice to pay in full or enroll in a payment plan. We do not accept cash payments, instead you can use a cashier's check but your enrollment will take longer.
Your enrollment application is confirmed within a few hours and could take about 3 weeks for mailing.
For cremation pre-planning, some of our funeral homes/crematories require two witness signatures. Your pre-planning counselor can serve as one witness. We recommend you bring a friend or family member as the second witness, both to fulfill this requirement and to ensure someone close to you is aware of your arrangements. Ideally, this second witness would be a family member likely to be involved in your final arrangements.
The funeral home will keep this hardcopy to process your permit and death certificate when the time comes. Following are instructions how to complete:
Can't print? We'll do this during your visit.
Download PDFEnjoy peace of mind when traveling (unless your homebound).
Download PDFProtect My Heritage
2810 W. Charleston Blvd., #72, Las Vegas, NV 89102
Be the first to find out the latest in news, events, and promotions.
We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.