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How To Pre-Arrange Your Funeral


Family name: First name(s)
Name at Birth ( if different from above )
Date of Birth: No of years in NZ:

Place of Birth:    
   
Street Address: City:
 
Phone   Email:
 
Usual Occupation ( before retirement )
Ethnic Group   Maori Descent
 
Civil Honours ( eg. J.P. OBE etc)

Full Name:
Street Address:   City:
 


Family information required by Registrar of Births, Deaths & Marriages

Sons ages:    
Daughters ages:    
 

Fathers name:   Mothers name:
Fathers birth name ( if different )   Mothers Maiden name:
 
Occupation:   Occupation:
 

Married

Never Married
Widowed

 

 Permanently Separated
Marriage Dissolved

 

 Partnered or Defacto
 

If currently married
To Whom Married ( if wife include maiden name )::
Spouses date of Birth Your age at Marriage
 
Place of Marriage  
Previous Marriage (1)
To Whom Married ( if wife include maiden name )::
Spouses date of Birth Your age at Marriage
 
Place of Marriage  
Previous Marriage (2)
To Whom Married ( if wife include maiden name )::
Spouses date of Birth Your age at Marriage
 
Place of Marriage  

Burial

Cremation
Place of burial ( if applicable )
Ashes to be placed / scattered at ( if applicable )
Furneral Service at:
Church

Funeral Home Chapel
Home

 

 Other Location
Service to be conducted by
Details of service and any special instructions
( include Hymns, Songs, Readings, Flowers, Casket etc )

Name of Family Doctor
Address of Family Doctor  
Name of Solicitor  
Address of Solicitor  
Name of Executor(s)  
Date of Last Will  
Will Held By