HUCKLEBERRY CREEK Future Pre-Plan Form

WELCOME to our innovative Cremation FUTURE PRE-PLAN FORM. This form is for planning Future arrangements and is NOT for At-Need or Imminent Arrangements. If a death has occured or is pending and you are looking to do an At-Need or Imminent Arrangement, please CLICK HERE. Payment can be made after completing the form or the form may be submitted as a quote to coordinate other payment arrangements. Monthly payments are available for 2 and 3 years. After you submit the form, we will follow up with you to get a few documents signed which will allow us to place your prepaid funds into a third-party trust (required by law).

Please call us with any questions or concerns: 360-868-2594

FAMILY CONTACT INFO

Name of Future Client*:

Name of Person Completing Form*:

Relationship of Person Completing Form*:

Best Contact Phone Number*:

Email*:

FUTURE PRE-PLAN CREMATION PACKAGE

GPL Acknowledgment*:

I have reviewed the General Price List online

Includes:

Pickup and Transport of the decedent (<300lbs) from another Funeral Home, Hospital, Coroner/Medical Examiner’s office, Nursing Home, or Residence (in King, Kitsap, Lewis, Mason, Pierce, Thurston, Grays Harbor, Jefferson, and Pacific counties
Refrigeration of the decedent (10days)
Cardboard Cremation Tray
Cremation process
Obtain Death Certificates (cost of DCs not included)
Black Plastic Urn.
Complimentary Shipping of Urn in WA.

Does not include any government fees or any other other product or service not listed here.

Simple Cremation Package*:

Select Rush Cremation*:

Select Client Weight*:

Viewing Acknowledgement*:

Take Fingerprint for Jewelry*:

Take Locket of Hair*:

Instructions for returning the cremated remains*:

Name & Address for Shipping Ashes:

How many Death Certificates?*:

Instructions for returning Death Certificates*:

Name & Address for Mailing DCs:

Required WA State Fee*:

WA State Cremation Fee ($10.80)

Anticipated County of Death Permit Fee*:

Complete Flag App & Retrieve US Flag*:

Schedule National Cemetery:

Upload Discharge Paperwork (DD214):

Please select how your heard about our firm*:

Choose Pay in Full or Monthly Payment *:

Third-Party Acknowledgement*:

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HUCKLEBERRY CREEK Future Pre-Plan Form

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