Planning

Start the Planning Process

To start the planning process, please fill out the form below to your best ability. After submitting, a member of our staff will contact you with the next steps. If you’d rather talk to us in person, please call (562) 947-1960.

Your Contact Information

Your First Name: *

Your Last Name: *

Your Email: *

Your Phone: *

Your Address:

Street:

Street 2:

City:

State:

Zip Code:

Decedant’s Information

What is your relation to the decedent?

What type of service are you interested in?

Decedent’ First Name:

Decedent’ Middle Name:

Decedent’ Last Name:

Also Known As (AKA): Include Full AKA (First, Middle, Last)

Decedent Sex:

Date of Birth:

Date of Death:

Decedent Age (Years):

Decedent Age (Months): If Under One Year

Decedent Age (Days): If Under One Year

Decedent Age (Hours): If Under 24 Hours

Decedent Age (Minutes): If Under 24 Hours

Decedent Birth State/Foreign County:

Social Security Number:

Ever In U.S. Armed Forces?:

Marital Status: At time of death

Was Decedent Hispanic/Latino(a)/Spanish?:

Education: Highest Level/Degree

Usual Occupation: Type of work for most of life. DO NOT USE RETIRED.

Kind of Business or Industry: (e.g., grocery store, road construction, employment agency, etc.)

Years in Occupation:

Decedent’s Residence:

Street:

Street 2:

City:

State:

Zip Code:

Years In County:

Surviving Spouse First Name:

Spouse Middle Name:

Spouse Last (Maiden) Name:

Father’s First Name:

Father’s Middle Name:

Father’s Last Name:

Father’s Birth State:

Mother’s First Name:

Mother’s Middle Name:

Mother’s Last Name:

Mother’s Birth State:

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Start the Planning Process

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