Name: Address: City: State: Zip Code:
e-Mail Address:
Next of Kin or Administrator: Address: City: State: Zip Code: Phone:
At the time of my death, I would like for my body to be cared for by Funeral Home at the location.
I wish to be: Buried at Cemetery (I already have Section # , Lot # , Grave # ) Buried next to at Cemetery Cremated with my ashes buried at Cemetery Cremated with ashes return to my family for later disposition Other I wish to: Let my family and friends gather for a visitation period according to their wishes Visition just prior to funeral service Private visitation for family and close friends only Prefer no visitation at all I wish to: Establish an Advance Funeral Account to ease the financial burden on my loved ones Other I wish to: Have my funeral merchandise similar in value to what was chosen for Have my funeral expenses kept to a minimum cost Allow my family to choose It is my wish: That expressions of sympathy be left unspecified Expressions of sympathy go to my family in care of Expressions of sympathy go to my favorite charity Information to be included in my obituary: Work History: Company , Position Number of Years , Retired Religious affiliation or church membership: Professional Organizations or Memberships: List of living members of family that I wish to include in my obituary: (Please include relationship, wife, son, etc.) Additional information needed by the Funeral Home includes: Date of Birth Place of Birth Father’s Name Mother’s Name Mother’s Maiden Name Branch of Service Providing Sincere Service since 1938 Owen Funeral Homes 5317 Dixie Highway - 502.447.2600 9318 Taylorsville Road - 502.266.9655
I wish to: Let my family and friends gather for a visitation period according to their wishes Visition just prior to funeral service Private visitation for family and close friends only Prefer no visitation at all
I wish to: Establish an Advance Funeral Account to ease the financial burden on my loved ones Other
I wish to: Have my funeral merchandise similar in value to what was chosen for Have my funeral expenses kept to a minimum cost Allow my family to choose
It is my wish: That expressions of sympathy be left unspecified Expressions of sympathy go to my family in care of
Expressions of sympathy go to my favorite charity
Information to be included in my obituary: Work History: Company , Position Number of Years , Retired Religious affiliation or church membership: Professional Organizations or Memberships: List of living members of family that I wish to include in my obituary: (Please include relationship, wife, son, etc.)
Additional information needed by the Funeral Home includes: Date of Birth Place of Birth Father’s Name Mother’s Name Mother’s Maiden Name Branch of Service
Providing Sincere Service since 1938 Owen Funeral Homes 5317 Dixie Highway - 502.447.2600 9318 Taylorsville Road - 502.266.9655
