Cremation Planning Info Only

Not In Use - Cremation Planning Form

PLEASE NOTE - Important information needed
Please choose a planning option:*
- Immediate Need
- Planning Ahead
If You Are in Immediate Need

If You Are in Immediate Need Call Affordable Cremation Services of New York (516) 279-2881.

If your loved one has just passed, we extend our deepest sympathies to you for your loss. Please call us first and notify us that a death has occurred. Completing this form does not notify us immediately.
Thanks for taking the time to fill out our Immediate Need Form. By completing the following information at your own convenience, you should find it easier to provide correct information and have some time to think about the type of services you desire.

The information provided on this form will help Affordable Cremation Services of New York complete the death certificate and other required documents. In addition, this information will assist our staff 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 send the information to us. You may also print out the form and bring it with you to the arrangement conference or fax.

If you have any questions whatsoever, please contact Affordable Cremation Services of New York at: 516-546-4626
Begin Form:
We need to have a minimum of information in order for us to process your cremation arrangement. In order to simplify the process, you may enter only some of the information now and complete the remaining information upon completing your transaction or at a later date.

Please choose below if you would prefer to provide as much information as you can now, or if you would prefer to wait.
Information Form Options*
- I would prefer to provide as much information now as possible
- I would prefer to provide more details later.
Information About the Person Completing This Form
First Name*
Last Name*
Middle Name
Your Address
Street Address City State ZIP Code
Email*
County
Phone
Person for whom I am filling for:*
Deceased Vital Statistics for Death Certificate
Deceased First Name*
Deceased Last Name*
Middle Name
Race
Spanish Decent?
Gender
Date of Birth
Month
Day
Year
Place of Birth
City of Death
State of Death
Country of Death
Deceased Location
Street Address Address Line 2 City State ZIP Code
Location of Death

(Ex: Hospital name, emergency room, name of nursing home, in transit, etc.)
Education
Usual Occupation (most of life)
Kind of Busines
Company
Company Location
Marital Status
Full Name of Surviving Spouse
If Wife, Provide Maiden Name
Residence - Street Address
City
Inside City Limits
County
State
Zip Code
Length of Residence In County
Father's Full Name
Mother's Full Maiden Name
Type of Disposition
Indicate Preference for Disposition of Ashes
Cemetery
Cemetery Section
Cemetery Phone
I Have Made a Last Will and Testament
Veteran Information
Was Decendent Ever In the US Armed Forces?
Branch of Serivce
Date Enlisted
Date Discharge
Honorable Discharge
Military Serial Number
Is a copy of discharge papers available?
Informant/Person In Charge Information
First Name*
Middle Name
Last Name*
Relationship to deceased
Email Address
Address
Street Address Address Line 2 City State ZIP Code
Phone
Funeral/Memorial Service Information
Preferred Place of Service
Reilgious Denomination
Funeral/Memorial Service Information
Please list any other instruction or information you would like us to have
Comments
This field is for validation purposes and should be left unchanged.

March 13, 2016

There are no words to express my appreciation for the manner in which this company responded to me and my family in our moment of terrible need. From the very first inquiry, I felt confident that everyone at Affordable was dedicated to making a painful and heartbreaking experience as comfortable and tolerable as possible. My family had several unusual requests and whatever we asked, as long as it was legal, they did it. I will always be grateful for their consideration, professionalism, sensitivity and compassion. I can try to move on knowing that my wife was in good hands in the end, and that everything about the process was respectful of her persona in life and her wishes in death. Do not be fooled by the name “affordable”. There is nothing cheap or cut-rate about what they do or how they do it. I couldn’t have been more satisfied even if I had paid ten times as much.

On behalf of my entire family, thank you!

Sincerely,

Alan Perlman

- Alan Perlman

Cremation Planning Info Only

Not In Use - Cremation Planning Form

PLEASE NOTE - Important information needed

If You Are in Immediate Need

Begin Form:

Information About the Person Completing This Form

Deceased Vital Statistics for Death Certificate

Type of Disposition

Veteran Information

Informant/Person In Charge Information

Funeral/Memorial Service Information

Funeral/Memorial Service Information