KILEY Funeral Home
 
About Us | Merchandise | Veterans Benefits | Costs
Cremation | Advanced Planning | Condolences
 

Advanced Planning

On-line Advance Planning

The following form will help guide you in making decisions and will organize information needed to complete required documentation, obituaries and services. When this form is complete you may e-mail it to us using the submit button, fax it to us at (207) 989-3337 or print and mail it to Kiley Funeral Home, 69 State St., Brewer, Maine 04412

Kiley Funeral Home will make every effort to provide the type of service that you or your family desires. It may be personalized in a way that would make it most meaningful and appropriate for you. Please let us know of any special requests that you may have.

Please complete the following form to begin the advance planning process.

Personal Information
Name
(First, Middle, Last):
Marital Status:   Social Security#: collected privately  
Date of Birth: Place Of Birth:
Address:
City: State:
County: Zip:
Phone: E-mail:
Spouse's Name: Spouse's Maiden Name:
Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:

Work/Education History
Education(0-12): College 1-5+:
Occupation:
Business: Company:

Military Record
Branch of Service: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge On File At:
Copy of Discharge Papers:     Yes     No
Name Of Wars:

Obituary Information
Survivor Name Relationship City State

Service & Disposition Requests
I Wish To Be:    Buried     Cremated     Other
Cemetery:
Viewing Or Visitation Prior?:    Yes     No  
Private or Public Viewing?:    Private   Public
Place of Ceremony:    Funeral Home     Church     Graveside   Other
Ceremony Officient:    Clergy     Family     Provided By Funeral Home

Other Information | Special Instructions
Person(s) To Finalize Arrangements At Time Of Death
Name:
Relationship:
Address:
Daytime Phone: Evening Phone:
Second Contact
Name:
Relationship:
Address:
Daytime Phone: Evening Phone:

 

 

 

 

 
 
info@kileyfuneralhome.com ~ 69 State Street ~ Brewer, ME 04412 ~ 207.989.3311