Pre-Need Form

Expressing personal preferences concerning the type of funeral service and related items that you want, is a good idea. It saves others you care about from guessing your desires and making difficult decisions at a stressful time.

We can visit in the privacy of your home, so that, planning can be done in a relaxed atmosphere.

Pre-funding a Funeral
Besides preplanning, we also offer the option to pay in advance. Payment can be made in a lump sum or by payment plans tailored to your needs. An approved Pennsylvania trust or insurance program is used as a depository for the prepaid funds.

Funds are not paid to the funeral home. In accordance with PA Law, 100% of those funds are sent directly to the insurance company or trust. The funds are held by that institution until death occurs, whereupon the funds are sent to the funeral home. Services and merchandise of fully funded funerals are guaranteed to be paid in full, no matter when death occurs.

Pre-funded funerals are transferable and excess funds are returned to the family.

”Putting Your House in Order” Program (Free Legal Planning)
In pre-arranging funerals for folks, we have learned that many people need more than just funeral planning. In many instances, legal planning is also needed. Perhaps, wills need to be written or updated, or Living Wills need written or Power-of-Attorney needs to be designated. Perhaps, there are other Elder Law issues.

Because of this need for legal planning, we offer to any person who pre-arranges a funeral with us, a free one-hour consultation with an attorney. There are 8 attorneys that are providers in our program and a person may select from any of these reputable and recommended attorneys to receive that free consultation.

The funeral only needs to be pre-arranged with our firm. It is not necessary to pre-pay the funeral.

Pre-Arranging a Funeral On-Line.
By completing the information on the following form, a person can basically preplan a funeral on-line. In Pennsylvania, according to Pa. Funeral Director Law, Section 13, only a licensed funeral director may shall, directly or indirectly, offer to enter into a contract to render funeral services. So, be sure, one will be contacted by a member of our licensed staff to verify the information and offer to contract to provide the pre-arranged funeral if arranged on-line.


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Personal Information
Name
(First MI Last):
Marital Status:   Social_Security #:
Date of Birth: Place Of Birth:
Address:
City: State:
County: Zip:
Phone: E-mail:
Spouse's Name: Spouse's Maiden Name:
Place of
Marriage:
Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:


Work/Education History
Education (0-12): College 1-5+:
Occupation:
Business: Company:
Schools Attended and Graduation Years

Military Record
Branch of Service: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge On File At:
Copy of Discharge Papers:     Yes     No
Name Of Wars:

Funeral Service Request
Place Of Service:
Funeral Home:
Length of Visitation:
Religious Denomination:
Place Of Worship:

Newspaper Information (
Please list family members)
Children:
Brothers/Sisters:
Number of Grandchildren:
List any other significant relatives :

Products and Services
Urn Selection
from "Cremation"
Casket Selection
from "Prices and Services"
Burial Vault
from "Prices and Services"
Service Type
from "Prices and Services"


Special Instructions
Lodges, Organizations, and Offices held:
Jewelry:
Glasses:
Lodge / Union:
Person in Charge of Final Arrangements:
Clothing Preference: My own Other
Funeral Luncheon Site:


Disposition Request
I Prefer:
Cemetery:
Address: Phone:
Section:
I have made a last will and testament:     Yes     No
Location:

If Cremation, final disposition of
cremated remains should be?
Burial Location:
Scattering Location:
Received By:


Other Instructions

Memorials/Donations To Charity

Please select all that apply:
Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file



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E-mail: laniganfunerals@aol.com