Pre-Planning Information

Let Us Help With Paperwork

As I'm sure you can imagine, when a death occurs in our State, the laws mandate that several documents need to be completed. City of Oaks Cremation, LLC will complete those documents, obtain the Certified Death Certificates, notify the County and the Social Security Administration of the death by using the information the families provide.

Providing this information in advance will help make the process easier when the time comes.

Please only fill out this form if you've been instructed to do so by a member of our staff. Call with any questions 919-438-1649.

Individual's full legal name:

First

Middle

Last

Last name prior to first marriage:

Sex

Age at last birthday

County and state of birth:

County:

State

If other or foreign country, please specify:

Date of birth:

Marital Status:

Spouse's name

Individual's usual occupation:

Kind of business/industry:

Social Security Number:

Individual's residence:

Residence-State or Foreign Country:

If other or foreign country, please specify:

County:

Street and number:

City:

ZIP Code:

Is the residence within city limits?

Background:

Was the individual ever in the U.S. Armed Forces?

If yes, is a copy of the individual's military discharge papers available?

Education completed:

Individual of hispanic origin?

Please specify if necessary:

Individual's race:

Please specify if necessary:

Individual's father's full legal name:

First:

Middle:

Last:

Individual's mother's full legal name:

First:

Middle:

Last:

Email address:

Email address of the person submitting this form:

Point of contact after death:

Name of primary point of contact after the death:

Contact's relationship to individual:

Contact's address:

Street and number:

City:

State:

ZIP Code:

Contact's telephone number:

Additional questions:

Is the individual currently under hospice care?

Name of hospice provider:

Does the individual have a pacemaker?

Three (3) Certified Death Certificates are already included. Please note any additional certificates needed here.

Additional Death Certificates requested:

Total certificates you'll receive:

We are committed to making this process as easy as possible for you. Please do not hesitate to call us with any questions and/or concerns. We are available to you 24 hours a day / 7 days a week.

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