WARNER FUNERAL HOMES & CREMATORY a hometown funeral home with Deep Roots in the Community
Funeral Preplanning
Please fill out the form below as best as you can, and we'll contact you regarding preplanning arrangements.
* - required fields

Confidential Personal Information
Your Name: *
Your Address (Street):
Your Address (Line 2):
City:
State/Provence:
Zip/Postal Code:
Phone Number:
Email Address: *
Best Time to Contact You:
       
Your Date of Birth: *
(mm/dd/yyyy)
Social Security/Insurance Number:
Age of Spouse (if alive) Citizen of What Country:
Occupation: Birthplace: (city & state or provence)
Education: Place of Business:
Father's Name: Father's Birthplace:
Mother's Maiden Name: Mother's Birthplace:
       
Benefit Information
Military Service: Branch:
Date of Enlistment: Date of Discharge:
Service Number:    
       
Funeral or Memorial Service Preferences
Type:
City and State of Final Resting Place:  
Clergy:
Music, Readings, Etc.
Pallbearers:
Honorary Pallbearers:
Special Requests:
Clothing, Jewelry, Etc.:
Casket/Urn:
Burial Vault:
Flowers:
   
Preferences for Final Disposition Family Burial Property
Location:
Number of Spaces:
Which Space:
Other: (scattering, Mausoleum, entombment, etc.)
Preferences for Memorialization:
Additional Information:
       
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WARNER FUNERAL HOMES & CREMATORY
Spencer        Sutherland        Peterson        Everly
225 West 3rd Street • Spencer, IA 51301 • 712-262-3640 • Fax 712-262-1618