Funeral Planning Declaration Template
[Full Name]
[Address]
[City, State, ZIP Code]
[Email Address]
[Phone Number]
Date: [Date]
I, [Full Name], am making this Funeral Planning Declaration to state my wishes regarding my funeral, memorial, burial, cremation, and related final arrangements.
Date of Birth: [Date of Birth]
Address: [Address]
2. General Funeral Preference
I direct that my final arrangements be handled as follows:
☐ burial
☐ cremation
☐ donation, if permitted by law
☐ other lawful disposition: [Describe]
Additional general instructions, if any:
[Insert instructions]
3. Funeral or Memorial Service
My preferences for a funeral, memorial, visitation, wake, or other service are:
☐ no formal service
☐ private family service
☐ public service
☐ religious service
☐ celebration of life
☐ other: [Describe]
Preferred service details:
[Insert service wishes, timing, speakers, music, readings, or other requests]
4. Burial or Cremation Instructions
If I am buried, my preferences are:
[Burial location, cemetery, plot, casket, clothing, religious customs, or other details]
If I am cremated, my preferences are:
[Urn choice, scattering wishes, storage location, division of ashes, or other details]
5. Personal and Religious Wishes
My personal, cultural, or religious wishes regarding final arrangements are as follows:
[Insert religious rites, customs, clergy requests, ceremonial details, or personal instructions]
I would like the following person to assist with or be notified about my funeral arrangements:
Name: [Full Name]
Relationship: [Relationship]
Address: [Address]
Phone Number: [Phone Number]
Email Address: [Email Address]
Alternate Contact, if any:
Name: [Full Name]
Relationship: [Relationship]
Phone Number: [Phone Number]
If I have prepaid, reserved, insured, or otherwise arranged any funeral-related services, the details are:
[Funeral home, cemetery, policy number, contract number, prepaid arrangement details, or other information]
8. Additional Instructions
Any additional wishes regarding flowers, donations, obituary notices, clothing, photographs, guest list, or related matters are:
[Insert additional instructions]
9. Revocation of Prior Instructions
I revoke any prior written funeral planning instructions made by me to the extent they are inconsistent with this declaration, unless otherwise required by law.
10. Signature
Signature: __________________________
Name: [Full Name]
Date: [Date]
11. Witnesses or Notary
Witness 1 Signature: __________________________
Name: [Full Name]
Date: [Date]
Witness 2 Signature: __________________________
Name: [Full Name]
Date: [Date]
Notary, if required:
State of [State]
County of [County]
On this [Day] of [Month], [Year], before me, the undersigned notary public, personally appeared [Name of Signer], known to me or satisfactorily proven to be the person whose name is subscribed to this instrument, and acknowledged that they executed the same for the purposes stated herein.
Notary Public Signature: __________________________
Name: [Notary Name]
My Commission Expires: [Date]