Enter the name of the person who this document is being prepared for (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.
MPL01003
FamilyFamily and/or friendsUnknownOther person(s)
MPLANS01
BWho will most likely be making the Declarant's final arrangements?
MPL01007
{NEXT_?}
Person(s) who will make arrangements:#|
MPLANS01
gWhat are the Declarant's wishes regarding the persons who will make the Declarant's final arrangements?
{NEXT_?}
Declarant's clergypersonOther persons
MPLANS02
<Who should be notified at the time of the Declarant's death?
9To what institution will the Declarant's body be donated?
MPL04012
A copy is located:#|
MPLANS04
@Where is the Declarant's copy of the donation agreement located?
Complete the sentence by specifying the location of the Declarant's copy of the agreement. For example: A copy is located "with my personal papers in a safety deposit box at First Community Bank."
MPL04039
MPL04012
Any useful organsOnly certain organs
MPLANS04
MDoes the Declarant desire to donate any useful organs or only certain organs?
MPL04019
MPL04025
I donate the following organs:#|
MPLANS04
9What specific organs does the Declarant desire to donate?
MPL04025
Yes, a gift form has been completed.
MPLANS04
4Has the Declarant completed an anatomical gift form?
MPL04026
MPL04039
A copy is located:#|
MPLANS04
;Where is the Declarant's copy of the donation form located?
!"#$%&\To what institution will the Declarant's body be donated, if organ donation is not possible?
MPL04039
MPL04030
Yes, an alternate method will be described.
MPLANS04
If for any reason it is impractical to donate the Declarant's body or organs, does the Declarant intend to state another method for the disposal of his or her body?
{NEXT_?}
Yes, state donation desires.
MPLANS04
mDoes the Declarant wish to state his or her desires regarding the donation of the Declarant's organs or body?
MPL04003
{NEXT_?}
Buried (or other method)Cremated
MPLANS05
0Will the Declarant's body be buried or cremated?
MPL05024
MPL05004
I desired that my body:#| be buried.not be embalmed.[other treatment]
MPLANS05
.What should be done with the Declarant's body?
Select the phrase that best completes the sentence. If you choose this option, you will be asked to specify where you want your body to be buried.
Select this option if you desire that your body not be embalmed and be disposed of as soon as possible.
Select this option if you wish to state your own desires regarding the treatment of your body after death.
'()*+,-.\What is the name and address of the church or organization where the columbarium is located?
MPL05056
Dispose of my cremains as follows:#|
MPLANS05
0pWhat specific instructions does the Declarant have regarding the disposition of his or her cremains after death?
Use this space to state detailed instructions regarding how and where the Declarant's cremains should be disposed of after death.
{NEXT_?}
Other instructions:#|
MPLANS05
What other instructions, if any, does the Declarant wish to specify regarding the disposition and treatment of his or her body or cremains after death?
{NEXT_?}
MPL05056
Yes, include preferences.
MPLANS05
CDoes the Declarant wish to include burial or cremation preferences?
MPL05003
{NEXT_?}
Yes, state autopsy desires.
MPLANS06
XDoes the Declarant wish to state his or her desires regarding a post-mortem examination?
MPL06004
MPL06006
YesNo
MPLANS06
7Does the Declarant authorize a post-mortem examination?
MPL06006
Yes, state an autopsy may be required by law.
MPLANS06
dDoes the Declarant wish to state that he or she understands an autopsy is sometimes required by law?
{NEXT_?}
Yes, specify preferences.
MPLANS06
^Does the Declarant wish to specify his or her preferences regarding a post-mortem examination?
MPL06003
{NEXT_?}
YesNo
MPLANS07
GDoes the Declarant desire that services be held after his or her death?
MPL07065
MPL07005
Yes, a funeral should be held.
MPLANS07
1Does the Declarant desire that a funeral be held?
456789:;OWhat is the name and address of the facility where the visitation will be held?
MPL07060
Anyone wishing to attendFamily and friends only
MPLANS07
Who may attend the visitation?
MPL07062
The body:shall be present.shall not be present.
MPLANS07
>?@VDoes the Declarant wish to specify whether the body will be present at the visitation?
MPL07065
These arrangements should be made:#|
MPLANS07
AB[What instructions, if any, does the Declarant wish to specify regarding other arrangements?
{NEXT_?}
MPL07065
Yes, state desires about services.
MPLANS07
KDoes the Declarant wish to state his or her desires regarding the services?
MPL07003
{NEXT_?}
#The following musical selections:#|
"should be played at the:#|
MPLANS08
>What musical selections should be played and at which service?
Enter the name of a musical selection the Declarant desires to have performed at his/her service. You will be given the opportunity to specify musical selections for three services.
MPL08008
MPL08003
(I would like#| to
)| at my
+#| I would also like
,| to
-| at my
MPLANS08
6Who should be asked to sing or perform at the service?
Enter the name of a person or group to sing or perform at a service. You will be given the opportunity to specify singers/performers for three services.
MPL08042
MPL08008
Other requests:#|
MPLANS08
01YWhat other requests, if any, does the Declarant have regarding the music at the services?
{NEXT_?}
MPL08042
Yes, specify music.
MPLANS08
nDoes the Declarant wish to specify his or her preferences regarding the music to be performed at the services?
MPL08003
{NEXT_?}
I would like#|to read at my |.I would also liketo read at my |.The following should be read:
MPLANS09
CWhat are the Declarant's wishes regarding readings at the services?
Enter the name of a person to read at a service. You will be given the opportunity to specify readers and readings for three services. Use the P.I. Manager to select and paste a record.
MPL09012
I would like#|
to read at my |.
I would also like
to read at my |.
The following should be read:
MPLANS09
FWhat are the Declarant's wishes regarding readings at another service?
MPL09032
MPL09012
Other requests:#|
MPLANS09
!\What other requests, if any, does the Declarant have regarding the readings at the services?
{NEXT_?}
MPL09032
Yes, state reading desires.
MPLANS09
[Does the Declarant wish to state his or her desires regarding the readings at the services?
MPL09003
{NEXT_?}
Service: |Name: |[Include another speaker]Name: |[Include another speaker]Name: |[Include another speaker]Name: |[Include another speaker]Name: |
MPLANS10
4Who does the Declarant wish to speak at the service?
Enter the type of service at which the Declarant wishes to have people speak. You will be given the opportunity to specify speakers for three services.
MPL10013
Service: |
Name: |
[Include another speaker]
Name: |
[Include another speaker]
Name: |
[Include another speaker] Name: |![Include another speaker]"Name: |
MPLANS10
9Who else does the Declarant wish to speak at the service?
MPL10035
MPL10013
Other requests:#|
MPLANS10
#$\What other requests, if any, does the Declarant have regarding the speakers at the services?
{NEXT_?}
MPL10035
Yes, specify speaker(s).
MPLANS10
@Does the Declarant wish to specify the speakers at the services?
MPL10003
{NEXT_?}
I request that:flowers be used.there be no flowers.donations be made instead of flowers.
MPLANS11
MWhat are the Declarant's wishes regarding the use of flowers at the services?
MPL11007
&0Name: |
'1[Include address]
(2Address 1: |
)3Address 2: |
*4City: |
!+5State: |
",6Zip: |
#-7[Include country]
$.8Country: |
MPLANS11
RTo what organizations, if any, does the Declarant wish that contributions be made?
MPL11057
MPL11007
Other requests:#|
MPLANS11
9:XWhat other requests, if any, does the Declarant have regarding flowers or contributions?
{NEXT_?}
MPL11057
Yes, state flowers and or memorial fund desires.
MPLANS11
`Does the Declarant wish to state his or her preferences regarding flowers and or memorial funds?
MPL11003
{NEXT_?}
Casket/container already selectedFamily or friends to select a casket/container[Other cremains option][Other casket/container option]
MPLANS12
!aWhat are the Declarant's desires regarding a casket or container for his or her body or cremains?
AWho has the Declarant made casket or container arrangements with?
{NEXT_?}
Yes, specify casket type.
MPLANS12
NDoes the Declarant wish to specify the type of casket that should be selected?
MPL12014
MPL12029
Cloth-covered wood/fiberboardWoodMetalOther
MPLANS12
8What material should be used for the Declarant's casket?
MPL12016
MPL12018
MPL12026
MPL12029
I desire that my casket be made#of |.
MPLANS12
0What type of wood should be used for the casket?
Complete the sentence by describing the type of wood the Declarant desires. For example, pine, mahogany, oak, cedar, walnut, etc.
MPL12029
I desire that my casket be made#of |.
MPLANS12
1What type of metal should be used for the casket?
Complete the sentence by describing the type of metal the Declarant desires. For example, light gauge or heavy gauge metal, solid copper, solid bronze, etc.
MPL12029
I desire that my casket be made of#|
MPLANS12
.What type of casket does the Declarant desire?
Complete the sentence by describing the type of casket the Declarant desires.
MPL12029
Yes, state burial container desires.
MPLANS12
XDoes the Declarant wish to state his or her desires regarding an outer burial container?
MPL12030
{NEXT_?}
YesNo
MPLANS12
4Does the Declarant desire an outer burial container?
MPL12032
Burial vaultGrave linerFamily to decide
MPLANS12
\If the cemetery requires one, what type of outer burial container does the Declarant desire?
{NEXT_?}
I desire that my cremains be placed:#|
MPLANS12
0Where should the Declarant's cremains be placed?
{NEXT_?}
Casket or container desires:#|
MPLANS12
"DWhat are the Declarant's desires concerning the casket or container?
{NEXT_?}
Yes, state casket or container desires.
MPLANS12
TDoes the Declarant wish to state his or her desires regarding a casket or container?
6Who, if anyone, should serve as alternate pallbearers?
If desired, enter the name of an alternate pallbearer or use the P.I. Manager to select and paste a record. You are not required to name alternate pallbearers.
{NEXT_?}
MPL13011
Yes, name pallbearers.
MPLANS13
?Does the Declarant wish to state who will serve as pallbearers?
MPL13003
{NEXT_?}
Yes, state visitation desires.
MPLANS14
ODoes the Declarant wish to state his or her desires regarding visitation hours?
MPL14004
MPL14006
YesNo
MPLANS14
<Does the Declarant desire to have visitation hours arranged?
MPL14006
Yes, state marker or monument desires.
MPLANS14
UDoes the Declarant wish to specify his or her desires regarding a marker or monument?
MPL14007
MPL14013
YesNo
MPLANS14
)Does the Declarant wish to have a marker?
MPL14009
MPL14013
Inscription:#|
MPLANS14
5What, if anything, should be inscribed on the marker?
If desired, use this space to describe the inscription to be made on the marker. You are not required to specify an inscription.
Enter the name of a publication in which the Declarant's obituary should be published. Press "Next" if an obituary notice will not be published.
MPL14018
MPL14013
Other arrangements:#|
MPLANS14
DWhat other arrangements, if any, does the Declarant wish to specify?
If desired, use this space to describe any other arrangements the Declarant desires (for example, a military marker or special burial attire).
{NEXT_?}
MPL14018
Yes, state other wishes and instructions.
MPLANS14
BWould the Declarant like to mention other wishes and instructions?
MPL14003
{NEXT_?}
Yes, state wishes were discussed.
MPLANS15
Does the Declarant wish to state that he or she has discussed the wishes expressed in this document with his or her family and other appropriate persons?
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