Obituary Worksheet

The following obituary worksheet will allow you to plan for the services. Please print the worksheet out and use it as a guidance.

Deceased Information
First Name
Middle Name
Last Name
Address
City
State
Zip
Age
DOB
Place of Birth
Education Level in Years
Education

Parent Information
Fathers First Name
Fathers Middle Name
Fathers Last Name
Mothers First Name
Mothers Middle Name
Mothers Maiden Name

Deceased Military Information
Veteran/Branch of Service
Veteran/Branch Date (mm/dd/yyyy)
Veteran Flag
(Drape casket or to be folded in casket)
Flag is to be presented to
Military Honors

Additional Deceased Information
Career
Hobbies
Interests
Memberships

Deceased Marraige Information
Marriage to
Marriage Date (mm/dd/yyyy)
Location

Survivors
Parents of
Spouse of
Sons of
Sons of
Sons of
Sons of
Sons of
Daughters of
Daughters of
Daughters of
Daughters of
Daughters of
Brothers of
Brothers of
Brothers of
Brothers of
Brothers of
Sisters of
Sisters of
Sisters of
Sisters of
Sisters of
Grandchildren
Great-grandchildren
Nieces
Nephews
Preceded in death by

Funeral Service
Funeral Service Time Day Date
Location of Service
Visitation Time Day Date
Place of Burial
Clergy
Other (Memorials etc)

Other things to think about and bring to arrangement conference:
  • Clothing - dress as one normally does including underclothing
    (shoes or slippers are optional)
    We prefer long sleeves
  • Photo of Deceased for Obituary and for Hair Stylist
  • List of Pallbearers
  • Lunch - Location,Caterer, Menu, Quantity
  • Special Verse for Folder
  • Music for Service

Special Insturctions for Funeral Director
Jewelry
Flowers

Death Certificate Information
Deceased's usual occupation(before retiring)
Kind of Business
Business Name
Spouse First Name
Spouse Middle Name
Spouse Last Name
Living or Deceased
Address
City
State
Zip
Informant: Name
Relationship
Informant Address
Informant City
Informant State
Informant Zip
Informant Phone
Name of Doctor
Number of Death Certificates needed
Send to
Obituary in the following papers
Obituary on the following radio stations