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Pecos Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Pecos Funeral Home.
*Require fields

Person Completing this Form*:
Relationship*:
Email*:
 
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
Address:
(no P.O. Box)
City:
State:
Zip:
Date of Birth:
(mm/dd/yyyy)
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Degree:
Veteran: Yes No
Military Branch:
Dates of Service:
Occupation:
Spouse's Full Name:
(Wife's maiden name, if applicable)
Religious Affiliation/Congregation:
 
Family Member Information

Family Member #1

 
Funeral Arrangement Details
Person in charge of arrangements:
 
Place of service or gathering:
If Other, please specify:

 

Preference for final disposition:
If Other, please specify:
Cemetery:
Disposition of cremated body:
 

In the space provided below, please share any information that would be helpful in creating a meaningful service. (ie. favorite hobbies, places, music selections, poems, scripture, etc.)

Any final thoughts that should be shared?

 

Do you wish to be contacted to discuss the details
of these arrangements, cost or payment options? Yes No

If yes, how should we contact you:
Phone Number:

If no, we will keep this information on file until you or your surviving family requests it.

  security code
Enter Security Code:

 

NOTE:
Texas law requires sellers of prepaid funeral contracts to hold a permit issued by the Texas Department of Banking. For additional information regarding prepaid funeral contracts, go to the website located at: www.prepaidfunerals.texas.gov.

Ida Kingston
Born: 12/4/1943
Died: 10/12/2017
Hector Matta
Born: 8/27/1952
Died: 10/10/2017
Serjio Jurado
Born: 5/14/1974
Died: 10/9/2017
Felipa Abila
Born: 5/1/1922
Died: 10/8/2017
Orlando Contreras
Born: 7/3/1964
Died: 10/5/2017
Colleen Beauchamp
Born: 11/16/1929
Died: 9/20/2017
Simon Acosta
Born: 10/28/1946
Died: 9/18/2017
Raymundo Espudo Jr
Born: 12/5/1942
Died: 9/12/2017
Andres Ortega
Born: 11/30/1925
Died: 9/9/2017

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Pecos Funeral Home | 607 West 3rd St. | Pecos, TX 79772 | (432) 445-3302
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