Stewart Baxter Funeral and Memorial Services : Pre-Planning Form

Planning Ahead Makes Sense

Many people choose to plan their arrangements ahead of time. A good number of the countless details can be recorded and placed on file at the funeral home. This can save time and the potential stress associated with a death. In addition, there are also advantages to prepaying for funeral home services. Stewart Baxter places 100% of your money in trust accounts and held safe until the time of need. The account earns interest like a money market. This feature allows us to lock-in at today�s prices and saves your family money. The accounts are also a protected asset from Title 19. Call us and we can discuss this opportunity with you in more detail, of course without obligation. Or you may fill out the form below to begin the process immediately.

I am planning for:
Personal Information
Name:
Email Address:
Address:
City:
State:
Country:
Zip Code:
Phone Number:
Place of Birth:
Date of Birth:
Sex:
Citizenship:
Marital Status:
Spouse (with Maiden Name):
Father's Name:
Mother's Name & Maiden Name:
SSN:
Religous Preference:
Education
High School Name:
# of Years:
College Name:
# of Years::
Family Information: Please list the names of survivors and state their relationship to you, their spouse's names and the city in which they live as you wish to have them listed in the memorial. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, Others (Eg. Son: Joe Smith and his wife Paula of Milledgeville)
Survivors:
Preceded in Death by::
Additional Information:
Work History
Occupation:
Business:
Industry:
Company:
Number of Years:
Years Retired:
Military Service
Service Branch:
Serial Number:
Date Enlisted:
Rank at Discharge:
Date Discharged:
Discharge on File At:
Combat Action:
Funeral Preferences
My service preferences
Public:
Private:
Visitation/Gathering:
Public:
Private:
Place of Service:
Other:
My disposition preferences
Burial:
Entombment/Mausoleum:
Cremation:

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Jessie Gordon Clements