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Hart Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Hart Funeral Home.
*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:

 
Comanche McCracken
Born: 4/11/1918
Died: 9/20/2017
Rainey Salazar
Born: 5/1/1947
Died: 9/17/2017
Birdie Forrest
Born: 3/28/1933
Died: 9/10/2017
Samuel Rodriguez
Born: 12/17/1990
Died: 9/9/2017
Jimmy Charles
Born: 11/17/1961
Died: 9/5/2017
George Dunavin
Born: 8/26/1922
Died: 8/20/2017
Jackie Alberty
Born: 6/19/1942
Died: 8/12/2017
Christina Ashley
Born: 5/14/1954
Died: 8/12/2017
Marlene Livers
Born: 8/3/1966
Died: 8/11/2017

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Hart Funeral Home | 1506 N. Grand | Tahlequah, OK 74464 | 918-456-8823
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