OpenClose

Funeral Director ------ Open/Close Request Form

Please be advised Prices have Changed as of January 1, 2025

All open and close request must allow for two full business days of prep time before grave site service. It is the funeral directors responsibility to verify by phone this form has been received completed. We will not accept incomplete forms and payment is expected for services rendered when ordered. Canceled Check Fee of $100.00

Name of Deceased

Date of Death

Date of Birth

Authorizing Agent For Funeral (Relation to Deceased)

Authorizing Agent Phone:

Authorizing Agent Address:

Time and Date of Services to Be Preformed

Owner of Grave Name(s)

Location of Grave (if Known Section, Lot, Grave #)

Funeral Director Contact Person (Phone & Email)

Burial Container (Length/Width/Hight)

Burial Transit Number (If Known)

Payment due in full ( Check or Cashier's Check) Burial Transit form, Current Certificate of Insurance (Dated at least 30 before scheduled date of grave side service, (for Funeral Home / Vault Company / Lettering or Moment Company) must be submitted prior to burial. No Cash. We do not accept credit cards or Insurance assignments. Any additional questions please call.