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FOR IMMEDIATE SERVICE

If death has occurred, please accept heartfelt condolences from our family to yours.

Call us right away to assist you and to answer your questions at this very difficult time (800) 644-7700, text us at (209) 327-8724.

Please fill the following form and submit. We will contact you to start the arrangements.

Decedent’s Information:

    First Name

    Middle Name

    Last Name

    Aka

    Date of Birth

    Country or State of Birth

    Date of Death

    Social Security Number

    Ever in the US Armed Forces?

    Marital Status

    Highest Education Level

    Was Decedent Hispanic/Latino/Spanish?

    Decedent Race (May use up to 3 choices)

    choice 1

    choice 2

    choice 3

    Does Decedent have Pace Maker?

    Approximate weight

    Usual Occupation (do not use retired)

    Kind of Business (Agriculture, Transportation, Government, ...)

    Years in Occupation

    Decedent’s Address

    City

    Zip

    County

    Years in County

    Surviving Spouse

    Decedent’s Father

    Decedent’s Father Birth Country or State

    Decedent’s Mother

    Decedent’s Mother Birth Country or State

    Informant’s Information

    Informant’s Name

    Informant’s Relation

    Informant’s Address

    Informant’s Phone

    Informant’s E-mail