This required section allows the Declarant to indicate whether family and/or friends should have discretion regarding these final arrangements. Press [Ctrl+F1] for more information.
This optional section enables the Declarant to specify the clergyperson or other persons to be notified upon the Declarant's death. Press [Ctrl+F1] for more information.
This optional section permits the Declarant to specify which funeral home/funeral director should make the arrangements. Press [Ctrl+F1] for more information.
In this optional section the Declarant may state his/her wishes regarding anatomical gifts or the donation of the body to science. Press [Ctrl+F1] for more information.
In this optional section the Declarant specifies whether the body will be buried or cremated. This option may be applicable if a body/organ donation cannot be made. Press [Ctrl+F1] for more information.
This optional section permits the Declarant to state his/her preferences regarding an autopsy. Press [Ctrl+F1] for more information.
This optional section addresses the types of service(s) desired by the Declarant, if any. For example, a wake, visitation, memorial or funeral service. Press [Ctrl+F1] for more information.
This optional section enables the Declarant to specify musical selections for any service. An optional provision states who will play or sing. Press [Ctrl+F1] for more information.
In this optional section the Declarant may specify scriptures or other readings for any service. The Declarant may also designate who should be asked to be the reader. Press [Ctrl+F1] for more information.
This optional section allows the Declarant to name persons to make remarks about the Declarant's life at any service. Press [Ctrl+F1] for more information.
This optional section allows the Declarant to state his/her desires regarding flowers and memorial funds. Press [Ctrl+F1] for more information.
In this optional section the Declarant may specify the type of casket/container desired, and whether or not an outer burial container is desired. Press [Ctrl+F1] for more information.
This optional section states the names of individuals the Declarant has chosen to be pallbearers. The names of alternate pallbearers are also requested. Press [Ctrl+F1] for more information.
This optional section permits the Declarant to state other desires regarding his/her final arrangements. For example, visitation, markers, obituaries or other wishes. Press [Ctrl+F1] for more information.
This section requires the Declarant's signature. This Declaration is to be followed to the extent possible, although events may require changes to the arrangements. Press [Ctrl+F1] for more information.
This optional section permits the Declarant to list information to be published in his/her obituary. Press [Ctrl+F1] for more information.
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Memorial Services
MPLANS
The Memorial Services is a worksheet that provides an opportunity to state personal wishes regarding funeral or memorial services, including preferences regarding a choice of funeral home, burial versus cremation, flowers, speakers, music, and obituary notices.
!!!!!!! !!
Enter the name of the funeral director to be consulted in making arrangements at the time of the Declarant's death or use the P.I. Manager to select and paste a record.
Enter the funeral home's street address or edit the information as desired.
Enter the funeral home's extended street address or edit the information as desired.
Enter the city in which the funeral home is located or edit the information as desired.
Enter the state/province in which the funeral home is located or edit the information as desired.
Enter the funeral home's zip/postal code or edit the information as desired.
Enter an X to include the country in which the funeral home is located, if outside the United States.
Enter the country or edit the information as desired.
Enter the name of the Declarant or edit the information as desired. Use the P.I. Manager to select and paste a record. Press [Ctrl+F1] for more information regarding memorial services.
MPL01
! Declaration Section (1 of 16)
DECLARATION REGARDING FINAL ARRANGEMENTS
I wish to describe my desires and to facilitate the making of arrangements at the time of my death.
! My family will be in the best position depending upon the circumstances to do what is right. To assist them in that process I am providing the following information:
! My family and friends will be in the best position depending upon the circumstances to do what is right. To assist them in the process of making arrangements, I am providing the following information:
! I would like the wishes described in this document adhered to as much as possible.
Enter the name of the Declarant or edit the information as desired. Use the P.I. Manager to select and paste a record. Press [Ctrl+F1] for more information regarding memorial services.
Enter an X if the Declarant's FAMILY will be in the best position to make the Declarant's final arrangements. Circumstances at the time of death may require that the person making the arrangements modify the arrangements specified in this document.
Enter an X if the Declarant's FAMILY AND FRIENDS will be in the best position to make the Declarant's final arrangements. Circumstances at the time of death may require that the person making the arrangements modify the arrangements specified in this document.
Enter an X if the Declarant desires that the person making his or her final arrangements (whoever it may be) follow the desires stated in this document as closely as possible.
Enter an X to compose a sentence stating the Declarant's wishes regarding the person(s) who will make the Declarant's final arrangements.
Use this space to describe who will be responsible for making the Declarant's final arrangements.
MPL02
! Optional Notification Section (2 of 16)
!. NOTIFICATION.
! I desire that my clergyperson,
!, of
! at
!, ! !,
! Country: !,
be contacted immediately in order to offer assistance and comfort to my survivors.
Enter an X to include a section which allows the Declarant to specify who should be notified at the time of the Declarant's death (for example, a clergyperson at a religious organization). Press [Ctrl+F1] for more information.
Enter an X to provide the name and address of the clergyperson (for example, the Declarant's minister, priest, or rabbi) who will be notified at the time of the Declarant's death.
Enter the name of the clergyperson or use the P.I. Manager to select and paste a record.
Enter the name of the clergyperson's organization (for example, a church, mosque, or synagogue).
Enter the organization's street address or edit the information as desired.
Enter the organization's extended street address or edit the information as desired.
Enter the city in which the organization is located or edit the information as desired.
Enter the state/province in which the organization is located or edit the information as desired.
Enter the organization's zip/postal code or edit the information as desired.
Enter an X to include the country in which the organization is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X to include a paragraph regarding the notification of an organization (such as a church or synagogue) or clergyperson(s), or any other person(s) at the time of death.
Enter any information regarding the notification of religious organizations, clergyperson(s), or any other person(s) at the time of death.
MPL03
! Optional Funeral Home/Director Section (3 of 16)
!. FUNERAL HOME/DIRECTOR. I desire that
! of !,
!, ! !,
! Country: !,
be consulted in making the arrangements requested in this document, and modifying these arrangements as may be appropriate at the time of my death.
Arrangements have been made with
! of !,
!, ! !
! , Country: !
! , and a copy of those arrangements is attached to this document
Enter an X to specify which funeral home or funeral director should be consulted in making the arrangements requested in this document. Press [Ctrl+F1] for more information.
Enter the name of the funeral director to be consulted in making arrangements at the time of the Declarant's death or use the P.I. Manager to select and paste a record.
Enter an X to include the name of the funeral home to be consulted in making arrangements at the time of the Declarant's death.
Enter the name of the funeral home to be consulted in making arrangements at the time of the Declarant's death or edit the information as desired.
Enter the funeral home's street address or edit the information as desired.
Enter the funeral home's extended street address or edit the information as desired.
Enter the city in which the funeral home is located or edit the information as desired.
Enter the state/province in which the funeral home is located or edit the information as desired.
Enter the funeral home's zip/postal code or edit the information as desired.
Enter an X to include the country in which the funeral home is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X if the Declarant has made prearrangements with a funeral home or funeral director.
The program completes this field by transferring information from a previous section. This information may be modified without affecting earlier data. Use the P.I. Manager to select and paste a record.
Enter an X if a copy of the arrangements will be attached to this document. If prearrangements have been made, it would be a good idea to share this information with a friend or family member to assure that your arrangements are in accordance with your prearranged plans.
MPL04
! Optional Donation/Anatomical Gifts Section (4 of 16)
!. DONATIONS/ANATOMICAL GIFTS.
! I desire that my body be donated to
!, ! !,
! Country: !,
for anatomical science studies as provided in an earlier agreement.
! A copy of the agreement is located
! I desire that
! any of my organs which may be useful to others be taken for anatomical gifts, if possible.
! only the following organs may be taken for anatomical gifts:
! I have completed the appropriate form to make these gifts.
! A copy of the donation form is located
If my organ donation is not possible, then I desire that my body be donated to !,
!, ! !,
! Country: !,
If for any reason it is impractical to donate my body or my body is rejected for medical science studies, I desire that my body be disposed of as indicated below.
Enter an X if the Declarant wishes to make organ donations or to donate the Declarant's body for scientific study. Press [Ctrl+F1] for more information.
Enter an X if the Declarant wants to donate his/her body for scientific study. A separate agreement for such donation must be made between the Declarant and the institution to which the body will be donated. Press [Ctrl+F1] for more information.
Enter the name of the institution to which the Declarant desires to donate his/her body after death or use the P.I. Manager to select and paste a record.
Enter the institution's street address or edit the information as desired.
Enter the institution's extended street address or edit the information as desired.
Enter the city in which the institution is located or edit the information as desired.
Enter the state/province in which the institution is located or edit the information as desired.
Enter the institution's zip/postal code or edit the information as desired.
Enter an X to include the country in which the institution is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X to state where a copy of the donation agreement is located.
Use this space to specify where a copy of the agreement is located.
Enter an X if the Declarant wishes to make anatomical gifts of organs or other body parts. Press [Ctrl+F1] for more information.
Enter an X if ANY of the Declarant's organs are to be donated for anatomical gifts, if possible. Press [Ctrl+F1] for more information.
Enter an X to specify which organs are to be donated for anatomical gifts. For example, liver, heart, kidneys, bones and tissues. Press [Ctrl+F1] for more information.
Use this space to specify which organs are donated for anatomical gifts.
Enter an X if the Declarant has completed an anatomical gift form.
Enter an X to state where a copy of the anatomical gift form is located.
Use this space to state where the anatomical gift form is located.
Enter an X if the Declarant desires his/her body to be donated for scientific study, if organ donation is not possible.
Enter an X to include a statement regarding treatment of the body if it is impractical to donate the Declarant's organs or body, or if the body is rejected for scientific study. The Declarant's wishes regarding treatment of the body can be entered in the next section.
MPL05
! Optional Treatment of Body Section (5 of 16)
!. TREATMENT OF BODY.
[Burial Option]
! I desire that my body
! be buried in !,
!, ! !
! , Country: !
! , Lot Number: !
! not be embalmed and be disposed of as soon as possible.
[Cremation Option]
! I desire that my body
! be embalmed and displayed at my service, and then cremated.
! be immediately cremated.
! I would like my cremains to be
! buried in !,
!, ! !,
! Country: !,
! Lot Number: !,
! placed in a columbarium in
!, ! !,
! Country: !,
! disposed of as follows:
Enter an X to specify the Declarant's wishes regarding burial or cremation. This option may be appropriate if a body or organ donation cannot be made. Press [Ctrl+F1] for more information.
Enter an X if the Declarant desires that his/her body be disposed of by means other than cremation.
Enter an X if the Declarant desires his/her body to be buried.
Enter the name of the cemetery or use the P.I. Manager to select and paste a record.
Enter the cemetery's street address or edit the information as desired.
Enter the cemetery's extended street address or edit the information as desired.
Enter the city in which the cemetery is located or edit the information as desired.
Enter the state/province in which the cemetery is located or edit the information as desired.
Enter the cemetery's zip/postal code or edit the information as desired.
Enter an X to include the country in which the cemetery is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X to include the number of the lot in which the Declarant will be buried.
Enter the number of the lot in which the Declarant will be buried.
Enter an X if the Declarant desires that his/her body not be embalmed at the time of death and disposed of as soon as possible.
Enter an X to describe how the Declarant desires his/her body be disposed.
Complete the sentence by entering a description of how the Declarant desires his/her body be disposed.
Enter an X if the Declarant desires that his/her body be cremated at the time of death. Press [Ctrl+F1] for more information.
Enter an X if the Declarant desires that his/her body be embalmed and displayed at a service before cremation.
Enter an X if the Declarant desires that his/her body be cremated as soon as possible after death.
Enter an X if the Declarant desires that his/her cremains be buried or disposed of in a specific place. Cremains are the ashes and fragments which remain after the cremation process.
Enter an X if the Declarant desires to have his/her cremains buried in a specific cemetery.
Enter an X to include the number of the lot in which the cremains will be buried.
Enter the number of the lot in which the cremains will be buried.
Enter an X if the Declarant desires to have his/her cremains placed in a columbarium. A columbarium is a structure which contains small chambers for cremated remains.
Enter the name of the church/organization at which the columbarium is located or use the P.I. Manager to select and paste a record.
Enter the church/organization's street address or edit the information as desired.
Enter the church/organization's extended street address or edit the information as desired.
Enter the city in which the church/organization is located or edit the information as desired.
Enter the state/province in which the church/organization is located or edit the information as desired.
Enter the church/organization's zip/postal code or edit the information as desired.
Enter an X to include the country in which the church/organization is located, if outside the United States.
Enter an X to state detailed instructions regarding the disposition of the Declarant's cremains after death.
Use this space to state detailed instructions regarding the method and location of disposition of the Declarant's cremains after death.
Enter an X to include a paragraph detailing information regarding the disposition and treatment of the Declarant's body after death.
Use this space to include information regarding the disposition and treatment of the Declarant's body or cremains after death.
MPL06
! Optional Post-Mortem Examination Section (6 of 16)
!. POST-MORTEM EXAMINATION.
! do not
authorize a post-mortem examination (autopsy).
! [Optional if user has selected donation of body to science.]
I desire that my family or other appropriate person(s) request that no autopsy be performed so that my body may be donated to medical science. However, I understand that in some instances an autopsy will be required by law.
Enter an X to include a section regarding the Declarant's preferences regarding a post-mortem examination (autopsy). Press [Ctrl+F1] for more information.
Enter an X to state whether or not the Declarant authorizes a post-mortem examination, if appropriate.
Enter an X if the Declarant desires to have a post-mortem examination, if appropriate.
Enter an X if the Declarant prefers NOT to have a post-mortem examination. The circumstances of death may legally require that an autopsy be performed.
Enter an X if the Declarant plans to donate his/her body and/or organs to scientific study. In such situations, an autopsy should not be performed, unless circumstances of death legally require that an autopsy be performed.
$MPL07
! Optional Memorial/Funeral Service Section (7 of 16)
!. SERVICES.
! I desire that no service of any kind be held after my death.
! I desire that the following service(s) be held:
!. A funeral service at
!, ! !,
! Country: !,
! for anyone desiring to attend.
! which will be limited to family and close friends.
! The body
! shall
! shall not
be present.
!. A memorial service at
!, ! !,
! Country: !,
! for anyone desiring to attend.
! which will be limited to family and close friends.
! The body
! shall
! shall not
be present.
!. A wake at
!, ! !,
! Country: !,
! for anyone desiring to attend.
! which will be limited to family and close friends.
! The body
! shall
! shall not
be present.
!. A visitation at
!, ! !,
! Country: !,
! for anyone desiring to attend.
! which will be limited to family and close friends.
! The body
! shall
! shall not
be present.
I desire that the following arrangements be made:
Enter an X to include a section addressing the services, if any, desired by the Declarant. For example, this could be a funeral or memorial service, a wake and/or visitation. Press [Ctrl+F1] for more information.
Enter an X if the Declarant desires that NO SERVICE of any kind be held after his/her death.
Enter an X to specify the type(s) of service(s) the Declarant desires to have after his/her death.
Enter an X if the Declarant desires to have a FUNERAL SERVICE after his/her death.
Enter the name of the facility at which the funeral service will be held or use the P.I. Manager to select and paste a record.
Enter the facility's street address or edit the information as desired.
Enter the facility's extended street address or edit the information as desired.
Enter the city in which the facility is located or edit the information as desired.
Enter the state/province in which the facility is located or edit the information as desired.
Enter the facility's zip/postal code or edit the information as desired.
Enter an X to include the country in which the facility is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X if the Declarant desires that the funeral service be open to anyone wishing to attend.
Enter an X if the Declarant desires that the funeral service be limited to only family and close friends.
Enter an X to state whether or not the body will be present at the funeral service.
Enter an X if the body SHALL be present at the funeral service.
Enter an X if the body SHALL NOT be present at the funeral service.
Enter an X if the Declarant desires to have a MEMORIAL SERVICE after his/her death.
Enter the name of the facility at which the memorial service will be held or use the P.I. Manager to select and paste a record.
Enter an X if the Declarant desires that the memorial service be open to anyone wishing to attend.
Enter an X if the Declarant desires that the memorial service be limited to only family and close friends.
Enter an X to state whether or not the body will be present at the memorial service.
Enter an X if the body SHALL be present at the memorial service.
Enter an X if the body SHALL NOT be present at the memorial service.
Enter an X if the Declarant desires to have a WAKE after his/her death.
Enter the name of the facility at which the wake will be held or use the P.I. Manager to select and paste a record.
Enter an X if the Declarant desires that the wake be open for anyone wishing to attend.
Enter an X if the Declarant desires that the wake be limited to only family and close friends.
Enter an X to state whether or not the body will be present at the wake.
Enter an X if the body SHALL be present at the wake.
Enter an X if the body SHALL NOT be present at the wake.
Enter an X if the Declarant desires to have a VISITATION after his/her death.
Enter the name of the facility at which the visitation will be held or use the P.I. Manager to select and paste a record.
Enter an X if the Declarant desires that the visitation be open to anyone wishing to attend.
Enter an X if the Declarant desires that the visitation be limited to only family and close friends.
Enter an X to state whether or not the body will be present at the visitation.
Enter an X if the body SHALL be present at the visitation.
Enter an X if the body SHALL NOT be present at the visitation.
Enter an X to compose a paragraph regarding any other arrangements.
Use this space to describe the Declarant's instructions regarding other arrangements.
MPL08
! Optional Music Section (8 of 16)
!. MUSIC.
! I would like the following musical selections to be performed at my !:
! I desire that ! be asked to ! at my !.
! I also wish that ! be asked to ! at my !.
! I would like the following musical selections to be performed at my !:
! I desire that ! be asked to ! at my !.
! I also wish that ! be asked to ! at my !.
! I would like the following musical selections to be performed at my !:
! I desire that ! be asked to ! at my !.
! I also wish that ! be asked to ! at my !.
Enter an X to include a provision regarding musical selections to be performed at any service(s) after death. An optional provision allows the selection of persons or groups to play or sing. Press [Ctrl+F1] for more information.
Enter an X to specify musical selections to be performed at a particular service.
Enter the type of service.
Enter the name of a musical selection the Declarant desires to have performed at his/her service.
Enter an X to specify the name of a person or a group to sing or play at a service.
Enter the name of a person or group to sing or play at a service. Use the P.I. Manager to select and paste a record.
Enter the type of activity the person or group will perform at the service. For example, "play" or "sing".
Enter an X to specify the name of an additional person or group to sing or play at a service.
Enter the name of a person or a group to sing or play at a service. Use the P.I. Manager to select and paste a record.
Enter an X to compose a paragraph stating any other requests regarding musical selections and/or performers.
Use this space to state any other requests regarding the musical selections and/or performers at the Declarant's service(s).
MPL09
! Optional Readings Section (9 of 16)
!. READINGS.
I desire that ! be asked to read at my !.
! I also wish that ! be asked to read at my !.
! I would like the following to be read:
I desire that ! be asked to read at my !.
! I also wish that ! be asked to read at my !.
! I would like the following to be read:
I desire that ! be asked to read at my !.
! I also wish that ! be asked to read at my !.
! I would like the following to be read:
Enter an X to include a provision regarding scriptures or other readings for any service, including the selection of readers. Press [Ctrl+F1] for more information.
Enter the name of a person to read at a service or use the P.I. Manager to select and paste a record.
Enter the type of service.
Enter an X to specify the name of an additional person to read at a service.
Enter the name of a person to read at a service or use the P.I. Manager to select and paste a record.
Enter an X to specify the names of particular scripture or other readings desired by the Declarant at the service.
Enter the name of a particular scripture or other reading.
Enter an X to include additional desires regarding scriptures or other readings for any service.
Enter an X to compose a paragraph regarding the Declarant's preferences regarding scriptures or other readings for any service. The Declarant may also designate the reader(s).
Use this space to describe the Declarant's reading selections and/or preferred readers for any service.
MPL10
! Optional Speakers Section (10 of 16)
!. SPEAKERS.
I would like the following person(s) to speak at my ! if they would feel comfortable doing so:
! - !
! - !
! - !
! - !
I would like the following person(s) to speak at my ! if they would feel comfortable doing so:
! - !
! - !
! - !
! - !
I would like the following person(s) to speak at my ! if they would feel comfortable doing so:
! - !
! - !
! - !
! - !
Enter an X to name persons to speak at any service. For example, someone to make remarks about the Declarant's life or beliefs. Press [Ctrl+F1] for more information.
Enter the type of service.
Enter the name of a person to speak at the service or use the P.I. Manager to select and paste a record.
Enter an X to specify the name of another person to speak at the same service.
Enter an X to name persons to speak at a different type of service.
Enter an X to compose a paragraph regarding who should be asked to speak at a service for the Declarant. The Declarant may want to specify what types of remarks he/she prefers.
Use this space to describe the Declarant's preferences regarding speakers for any service.
MPL11
! Optional Flowers/Memorial Section (11 of 16)
!. FLOWERS/MEMORIAL.
! I request that
! flowers be used at the discretion of my family and friends.
! there be no flowers.
! donations made to the organizations listed below in lieu of flowers.
I request that a memorial fund be established with donations to be made to the following organizations:
!, ! !
! Country: !
!, ! !
! Country: !
!, ! !
! Country: !
!, ! !
! Country: !
!, ! !
! Country: !
Enter an X to select a provision which specifies the Declarant's desires regarding flowers and memorial funds. Later in this section the Declarant may compose a paragraph regarding these items. Press [Ctrl+F1] for more information.
Enter an X to select a statement regarding the Declarant's desires concerning flowers.
Enter an X if the Declarant prefers that any decisions regarding flowers be made by family and friends.
Enter an X if the Declarant requests that no flowers be purchased or displayed at any service.
Enter an X if the Declarant desires that donations be made in lieu of flowers.
Enter an X to specify the names of organizations to which memorial funds shall be donated.
Enter the name of an organization to which memorial funds shall be donated or use the P.I. Manager to select and paste a record.
Enter an X to include the address of the organization to which memorial funds shall be donated.
Enter the organization's street address or edit the information as desired.
Enter the organization's extended street address or edit the information as desired.
Enter the city in which the organization is located or edit the information as desired.
Enter the state/province in which the organization is located or edit the information as desired.
Enter the organization's zip/postal code or edit the information as desired.
Enter an X to include the country in which the organization is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X to include the name of an organization to which memorial funds will be donated.
Enter an X to include the name of an organization to which a memorial fund will be donated.
Enter an X to compose a paragraph regarding the Declarant's desires regarding flowers and/or memorial funds.
Use this space to describe the Declarant's desires regarding flowers and/or memorial funds.
MPL12
! Optional Casket/Container Section (12 of 16)
!. CASKET/CONTAINER.
! I have selected my casket/container on a prearranged basis with:
!, ! !
Country: !
! I desire that my family or other appropriate person making my arrangements select a casket/container that is consistent with my tastes.
! I desire that my casket be made of
! cloth-covered wood/fiberboard.
! [wood]
! [metal]
! [other]
! do not
desire an outer burial container. I understand that the cemetery may require one and therefore, would prefer the outer burial container to be
! a burial vault.
! a grave liner.
! a selection made by my family.
! I desire that my cremains be placed
Enter an X to describe the Declarant's preferences regarding the selection of a container for his/her remains. For example, a casket and/or outer burial container, or container for the Declarant's cremains. Press [Ctrl+F1] for more information.
Enter an X if the Declarant has prearranged and paid for his/her casket and/or outer burial container.
Enter the name of the funeral home/director who the prearrangements have been made with or edit the information as desired. Use the P.I. Manger to select and paste a record.
Enter the funeral home/director's street address or edit the information as desired.
Enter the funeral home/director's extended street address or edit the information as desired.
Enter the city in which the funeral home/director is located or edit the information as desired.
Enter the state/province in which the funeral home/director is located or edit the information as desired.
Enter the funeral home/director's zip/postal code or edit the information as desired.
Enter an X to include the country in which the funeral home/director is located, if outside the United States.
Enter the country or edit the information as desired.
Enter an X if the selection of a casket and/or outer burial container should be made by the Declarant's family or other appropriate person. Press [Ctrl+F1] for more information.
Enter an X if the Declarant wishes to specify the type of casket to be purchased by a family member or other appropriate person. Local inquiries may provide an idea of the price range of the various alternatives.
Enter an X if the Declarant desires a CLOTH-COVERED/FIBERBOARD casket. This is generally the least expensive alternative.
Enter an X if the Declarant desires a WOODEN casket.
Enter the type of wood that should be used for the casket. For example, pine, mahogany, oak, cedar, walnut, etc.
Enter an X if the Declarant desires a METAL casket.
Enter the type of metal that should be used for the casket. For example, light gauge or heavy gauge metal, solid copper, solid bronze, etc.
Enter an X to compose a detailed description of the type of casket the Declarant desires.
Use this space to describe the type of casket the Declarant desires.
Enter an X to specify whether or not the Declarant desires that an outer burial container be purchased. Some cemeteries may require such a container to avoid the collapse of the ground around the casket. Press [Ctrl+F1] for more information.
Enter an X if the Declarant DESIRES an outer burial container. Such container is designed for placement in the grave around the casket.
Enter an X if the Declarant DOES NOT DESIRE an outer burial container. An outer burial container is generally not required by law. Some cemeteries (and city or county ordinances) require outer burial containers to maintain the orderly appearance of the cemetery.
Enter an X if the Declarant desires that the outer burial container be a VAULT. A vault is the most expensive type of container and is generally made of steel, concrete or fiberglass. Press [Ctrl+F1] for more information.
Enter an X if the Declarant desires that the outer burial container be a GRAVE LINER. These are less expensive and are generally made of concrete boxes or sections of concrete. Press [Ctrl+F1] for more information.
Enter an X if the Declarant desires that the outer burial container be selected by the family. This option allows the family to consider the requirements of the cemetery and the alternatives available at the time of the Declarant's death.
Enter an X to specify the treatment of the Declarant's cremains. For example, what type of container or where the container should be placed.
Use this space to describe the Declarant's desires regarding the placement of his/her cremains.
Enter an X to compose a paragraph describing the Declarant's specific desires regarding the selection of a casket or container for his/her remains.
Use this space to describe the Declarant's desires regarding the selection of the casket/container for his/her remains.
MPL13
! Optional Pallbearers Section (13 of 16)
!. PALLBEARERS.
I would like the following persons to serve as pallbearers:
If any of the persons named are unable to serve for any reason, I would like the following persons to serve as alternate pallbearers:
Enter an X to include a section which allows the Declarant to name pallbearers and alternates. Friends and relatives are generally named pallbearers as a designation of honor. Press [Ctrl+F1] for more information.
Enter the name of a pallbearer or use the P.I. Manager to select and paste a record.
Enter an X to list the names of alternate pallbearers if one of the above named pallbearers is unable or unwilling to serve.
Enter the name of an alternate pallbearer or use the P.I. Manager to select and paste a record.
MPL14
! Optional Other Wishes Section (14 of 16)
!. OTHER WISHES.
! I also desire that
! there be no visiting hours and no display of my body.
! visiting hours be arranged.
! do want a marker.
! do not want a marker.
! I request the following information be inscribed on the marker:
I would like an obituary notice to be published in:
! Biographical information is attached to this declaration.
Enter an X to include a section containing additional instructions regarding final arrangements. This section includes provisions regarding visitation, markers, obituaries, and other wishes. Press [Ctrl+F1] for more information.
Enter an X to include a provision regarding visitation.
Enter an X if the Declarant desires that there be no visitation or display of his/her body.
Enter an X if the Declarant desires that visitation hours be arranged. Visitation is a form of grief therapy and acceptance of the death. Family and friends also support one another during the visitation.
Enter an X to include a provision regarding a marker or other monument. Some cemeteries require that markers be flush to the ground. Press [Ctrl+F1] for more information.
Enter an X if the Declarant WANTS a marker.
Enter an X if the Declarant DOES NOT WANT a marker.
Enter an X to describe the inscription to be made on the marker.
Use this space to describe the inscription to be made on the marker.
Enter an X to list the publications in which the Declarant desires that his/her obituary be published.
Enter the name of the publication in which the Declarant's obituary should be published.
Enter an X if the Declarant is attaching information to be published in his/her obituary. Such an attachment is presented later in this document or the Exhibit document can be used for this purpose.
Enter an X to compose a paragraph describing any other arrangements the Declarant desires. For example, military markers or burial attire.
Use this space to describe any other arrangements the Declarant desires.
MPL15
! Declarant Signature Section (15 of 16)
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 family and other appropriate person(s) based on the circumstances at the time of my death. I hope that my desires will be fulfilled, to the extent possible.
! I have discussed these instructions with my family and all appropriate persons.
Enter an X to include a sentence stating that the Declarant has discussed these instructions with his/her family and all appropriate persons. Although the Declarant has given these instructions serious consideration, circumstances may require that the stated instructions be modified. Press [Ctrl+F1] for more information.
The program completes the Declarant's name by transferring the information from a previous section. This information may be modified without affecting earlier data.
Enter the Declarant's street address or edit the information as desired.
Enter the Declarant's extended street address or edit the information as desired.
Enter the Declarant's city or edit the information as desired.
Enter the Declarant's state/province or edit the information as desired.
Enter the Declarant's zip/postal code or edit the information as desired.
Enter an X to include the Declarant's country, if outside the United States.
Enter the country or edit the information as desired.
MPL16
! Optional Biographical Information Section (16 of 16)
BIOGRAPHICAL INFORMATION
FULL NAME: !
PLACE OF BIRTH: !, !
DATE OF BIRTH: !
SOCIAL SECURITY NUMBER: !
NAME OF SPOUSE: !
! DATE OF DEATH (if spouse deceased): !
NAME OF FATHER: !
! DATE OF DEATH (if father deceased): !
NAME OF MOTHER: !
! DATE OF DEATH (if mother deceased): !
OTHER SURVIVORS:
SCHOOLS ATTENDED:
ORGANIZATIONS:
MILITARY SERVICE:
PUBLIC OFFICES HELD:
ASSOCIATIONS:
OTHER INFORMATION:
Enter an X to create an attachment containing biographical information to be published in the Declarant's obituary.
Enter the Declarant's full name or edit the information as desired. Use the P.I. Manager to select and paste a record.
Enter the city in which the Declarant was born.
Enter the state/province in which the Declarant was born.
Enter the Declarant's date of birth or edit the information as desired.
Enter the Declarant's social security number or edit the information as desired.
Enter an X to include the name of the Declarant's spouse.
Enter the full name of the Declarant's spouse or use the P.I. Manager to select and paste a record.
Enter an X to include the spouse's date of death, if the spouse is deceased.
Using the format MM/DD/YYYY, enter the spouse's date of death.
Enter an X to include the name of the Declarant's father.
Enter the full name of the Declarant's father or use the P.I. Manager to select and paste a record.
Enter an X to include the father's date of death if the father is deceased.
Using the format MM/DD/YYYY, enter the father's date of death.
Enter an X to include the name of the Declarant's mother.
Enter the full name of the Declarant's mother or use the P.I. Manager to select and paste a record.
Enter an X to include the mother's date of death, if the mother is deceased.
Using the format MM/DD/YYYY, enter the mother's date of death.
Enter an X to include the names of other persons surviving the Declarant.
Use this space to list the names of other persons surviving the Declarant.
Enter an X to list the names of schools attended by the Declarant.
Use this space to enter the names of schools attended by the Declarant.
Enter an X to list the names of organizations to which the Declarant belonged.
Use this space to enter the names of organizations to which the Declarant belonged.
Enter an X to describe the Declarant's military service.
Use this space to describe the Declarant's military service.
Enter an X to list public offices held by the Declarant.
Use this space to list public offices held by the Declarant.
Enter an X to list associations of which the Declarant was a member.
Use this space to list the names of associations of which the Declarant was a member.
Enter an X to include any other information regarding the Declarant.
Use this space to include any other additional information regarding the Declarant.
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