Contact Person
Name*
First Middle Last
Address*
Street Address City Province Postal Code
Email
Phone*
Cell Phone
Work Phone
Relationship to Deceased*
Deceased Person Information
Name*
First Middle Last
Sex*
Date of Death*
MM slash DD slash YYYY
Place of Death
Facility Name(If applicable)
Address*
Street Address City Province Postal Code
Date of Birth*
MM slash DD slash YYYY
Birthplace: City, State, Country*
Deceased's Residence*
Street Address City Province Postal Code
Marital Status*
Name of Spouse (maiden name, if wife)
Branch of Service*
Years of Service*
SIN

The SIN is required to complete the arrangements. If you don't feel comfortable entering the information here, we will call you by telephone to retrieve the SIN.
Usual Occupation*
Kind of Business/Industry*
Father
Father's Name*
First Middle Last
Legal forms require this information. If you do not have this information, 'Unknown' will need to be inserted.
Step-Father Name
Birthplace: City, Province, Country
Mother
Mother's Name*
First Middle Last
Legal forms require this information. If you do not have this information, 'Unknown' will need to be inserted.
Maiden (last) Name*

Legal forms require this information. If you do not have this information, 'Unknown' will need to be inserted.
Step Mother Name
Birthplace: City, Province, Country
Cemetery Information
Cemetery Name
Location City/Location State of Cemetery

Contact Person

Deceased Person Information