Death Instructions
To assist my survivors in making arrangements at the time of my death, I provide the following information:

1.NOTIFICATION. I desire that my clergyperson, ____________, of ______________be contacted immediately in order to offer assistance and comfort to my survivors.

2.  FUNERAL HOME/DIRECTOR.  I desire that ______________ of ________________
be consulted in making the arrangements requested in this document.  The arrangements have been made and are attached to this document as Exhibit 1.

3. TREATMENT OF BODY.  I desire that my body be buried in _________, Lot Number/Location: ______________.  Arrangements have been made and are attached in Exhibit 2.

4.SERVICES.  I desire that the following service(s) be held: ______________________

a. Visitation.  A visitation at _______________________, for anyone desiring to   attend.  The body may be present.
Music.  It is my desire to include the following music selection(s) at my visitation:
    _____________________________.
Readings.  It is my desire to include the following readings at my visitation:   
      ________________________

b. Memorial Service.  A memorial service at  ___________________________                                         
for anyone desiring to attend.  The body may be present.
        Music.  It is my desire to include the following music selections at my memorial
service: _________________________________________.
Readings.  It is my desire to include the following reading(s) at my memorial service: _________________________________________.
Speakers.  I would like the following people to speak: ____________________.

c. Funeral Service.  A funeral service at  _________, for anyone desiring to attend.  The body may be present.
        Music.  It is my desire to include the following music selections at my memorial
service: _________________________________________.
Readings.  It is my desire to include the following reading(s) at my memorial service: _________________________________________.
Speakers.  I would like the following people to speak: ____________________.

5. FLOWERS & MEMORIAL.  I request that donations be made to the organizations listed below in lieu of flower: ___________________________-.

6. CASKET/CONTAINER.  I have selected my casket/container on a prearranged basis with the funeral director named in #2 above.

7.PALLBEARERS.  I would like the following persons to serve as pallbearers: _____________________________________________________________.



8.OTHER WISHES.  I would like a marker placed on my gravesite as listed in the instructions left with the Funeral Director in #2 above.  I would like an obituary notice similar to the one attached in Exhibit 3 used and sent to the following periodicals: _________________________________________________.

9.  PERSON TO HANDLE THESE DETAILS.  Given the other issues surrounding my death, I suggest that ___________ be appointed to handle the administration of the above events.  This will remove pressure from the family and create a less stressful series of events.

I have given careful thought and consideration to these instructions.  I understand that this declaration is not legally binding, and that the ultimate decision will be made by my survivors based on the circumstances at the time of my death.  I hope that my desires will be fulfilled, to the extent possible.

Dated:  

______________________
Signature:

 
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