Start Planning Cremation | Rochester Cremation

Which location to use?*

Greece
Henrietta

Select Type of Arrangement Needed*

Loved one has passed (Immediate Need)
Pre-planning (Preneed)

Date of Death*

Place of Death*

Legal Information

Name*

First Middle Last Suffix

Sex

Male
Female

Date of Birth

Place of Birth*

City State

Veteran Information

Did you ever serve in the armed forces?*

Yes
No

What Branch of Service?*

Hispanic Origin / Race / Education / Marital Status

Hispanic Origin

(Check the box that applies)

Race

(Check the box that best describes your race)

White/Caucasian
Asian
Black or African American

Education

(Check the box that best describes the highest degree or level of school completed)

Marital Status

Surviving Spouse

(If wife, First and Last maiden name)

Occupation

Most Recent Occupation

(Do not enter retired)

Place of Employment

(Last or longest)

Type of Business or Industry

Locality of Employment

City State

Current Address/Residence (of decedent)

Name of Facility

(If not facility, give address)

Address

Street Address City State ZIP Code

Parents

Name of Father

First Last

Maiden Name of Mother

First Last Maiden Name

Informant of Next of Kin

(Surviving spouse or person in charge of arrangements)

Name*

First Last

Relationship to Deceased*

Address*

Street Address City State ZIP Code

Work Phone*

Home Phone

Cell Phone

Email*

Alternate Contact

Name

First Last

Relationship to Deceased

Address

Street Address City State ZIP Code

Work Phone

Home Phone

Cell Phone

Email

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Start Planning

Legal Information

Veteran Information

Hispanic Origin / Race / Education / Marital Status

Occupation

Current Address/Residence (of decedent)

Parents

Informant of Next of Kin

Alternate Contact

Henrietta

(585) 359-2300

Greece

(585) 222-2300

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