Our Services - At Need

funeral & cremation services  :   at need  :   personalization  :   merchandise

In the event you are suddenly faced with a death in the family and need to make funeral arrangements, the following will give you an understanding of the type of information the funeral director will require.

The information provided on this form will help the funeral home complete the death certificate and other required documents. In addition, this information will assist the funeral director to better understand your initial wishes. Relaying required statistical information can be time consuming. Our desire is to help expedite the final arrangement conference at the funeral home and make the process a little more comfortable.

Please complete (as much as possible) the information on the form and select "Submit Information" at the end to email to the funeral home. You may also print out the form and fax it to us at (843) 248-3021 or bring it with you to the arrangement conference.

If you have any questions, please contact the funeral home at any time. Thanks again for helping us serve you more efficiently.

Deceased Statistical Info

Last Name:
First Name:
Middle Name:
Maiden Name:
Sex:
Race:
Date of Birth:
 /   / 
Place of Birth: City

State

OR Country
Date of Death:
 /   / 
City of Death:
State of Death:
County of Death:
Location of Death:
If other, please indicate address:
Name of the Place
of Death:
Social Security #:
Education
Usual Occupation:
(most of life)
Kind of Business:
Company: (optional)
Marital Status:
Surviving Spouse:
If wife, provide
maiden name:
Children:
Grandchildren:
Siblings:
Nieces:
Nephews:
Other relatives:
Preceded in death by:
Residence:
(street Address)
City/Town:
Inside City Limits:
County:
State:
Zip Code:
Length of Residence
in County:
Father's Full Name:
Mother's Full
Maiden Name:
 

TYPE OF DISPOSITION
Disposition will be:
          
If Cremation, disposition of ashes?:
          
Name of Cemetery (if applicable):
          
City:
State:
 

PREPARATION AND VIEWING


Important Note: Viewing of the body is a choice of the family. In most cases, embalming is required or recommended for public viewing/visitation, mausoleum entombment, or transfer of remains via common carrier (i.e. shipment by air or rail). When possible, the funeral home needs authorization from the next of kin for embalming.
The family preference regarding viewing/embalming is:
          
I authorize Goldfinch Funeral Home to embalm:
          
Name of authorizing person:
Relationship to deceased:
 

VETERAN INFORMATION
Was Decendent ever in the US Armed Forces?:
       YES NO (if no, continue to next section)
Branch of Service:
Date Enlisted:
 /   / 
Date Discharged:
 /   / 
Honorable Discharge: YES NO
Military Serial #:
Is copy of discharge papers available?
       YES NO (if yes, please bring for us to copy.)
 

INFORMANT INFORMATION
Name of person in charge:
Relationship to deceased:
Address:
City:
State:     Zip:
Phone #:
Email:
 

FUNERAL/MEMORIAL SERVICE INFO
Preferred Place of Service:
Religious Denomination (optional):
Does decedent have pre-arrangements?: YES NO
If yes, specify type:
 

SPECIAL INSTRUCTIONS
Note: Use box below to indicate any additional information that may be helpful at this time. Other details regarding services, merchandise, flowers, financing, etc., will be discussed and finalized at the arrangement conference.



PLEASE CALL FOR AN APPOINTMENT.

Thank you for completing our online arrangement form.





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