Merkle Funeral Service
Advanced Planning Forum
First Name:
Last Name:
Email Address:
House Number:
Street:
City:
State:
Zip:
Phone Number:
County:
Birthdate:
Birthplace:
Father's Name:
Birthplace:
Mother's Maiden Name:
Birthplace:
Current Spouse
Marital Status:
Married
Divorced
Single
Widowed
Spouse's Name:
Marriage Date:
Marriage Location:
Spouse's Death Date:
Previous Spouse
Marital Status:
Married
Divorced
Single
Widowed
Spouse's Name:
Marriage Date:
Marriage Location:
Spouse's Death Date:
Personal History
Occupation:
Employer:
Position Held:
How Long:
Year Retired:
Resident Cities Years:
Education:
Military Service:
Rate or Rank:
Service Number:
Enlistment Date:
Enlistment Place:
Discharge Date:
Discharge Place:
Lodges, Memberships,Church & Public Office Held:
General Biography for Media and Funeral Services Folders:
Final Wishes and Desires
Cemetery:
Location:
Section:
Lot:
Space:
Marker Installed:
Special Instructions:
If you have any questions please Email
info@merklefuneralservice.com
.