TEST FORM - PLANNING FORM - Affordable Cremation Services of New York Affordable Cremation Services of New York

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

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

Email

This field is for validation purposes and should be left unchanged.

TEST FORM – PLANNING FORM

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