Information Form

This is the information we will need in order to complete your prearrangement. You may communicate this information to our staff over the phone or if you prefer, you can enter the information below.

If you only have some of the information please fill out as much as you can. The remaining information can be later submitted here or communicated to us over the phone.

Purchaser's Information

Please enter the information of the person filling out this form.
Relationship to Beneficiary:
 
Name:  
Street Address:
City:  Phone:
Postal Code:  Email:
Next of Kin/Executor Information
Is there a will?
Yes
No
Unsure

In order to make arrangements at the time of need we will require the executor’s participation. If there is no will in place, the legal next of kin will be required to participate in the arrangements. Please enter the information of the executor or, if there is no will, the information of the legal next of kin.

If you, the informant, are the executor or next of kin:

Relationship to Deceased:
 
Name:
Street Address:
City: Phone:
Postal Code: Email:
Beneficiary's Information
Name:
Street Address:
City: SIN:
Postal Code:    

Date of Birth: City of Birth:
Martial Status:  Spouse:
Occupation for most of working life:
Father's Name:  Father's Place of Birth:
Mother's Maiden Name: Mother's Place of Birth:
Services
Cremation Burial Undecided

Would you like to purchase an urn?
Yes No

->If yes, what type of urn would you like?:

Would you like help settling your estate?
Yes No
Are you interested in the World Travel Plan?
Yes No
Are there any additional services you are considering?
Yes No

-> If yes, pleace specify:

Additional Notes:

Please enter the security code in the box below:

security code


Click to submit your information to Basic Cremations