Western Reserve Cremation

Deceased Information

Free Text

* Required Field

Deceased First Name *

Deceased Middle Name

Deceased Last Name *

Sex *

Race *

Marital Status *

Spouse (if applicable)

Date of Birth *

Birthplace

Occupation

Type of Business/Industry

Social Security No. *

Ever in Armed Forces?

Branch of Service

Education (Highest Level)

Deceased Street Address

Deceased City

Deceased State

Residence in City Limits?

Deceased Zip Code

Father's Name

Mother's Name

Mother's Maiden Name

Organizations, Hobbits, Interests

Does Deceased have a Pacemaker?

Next of Kin Full Name, Address, and Relation to Deceased

NO HIDDEN COSTS GAURANTEE

We gaurantee that if you are not 100% satisfied with any aspect of our service, we will make every effort to correct the situation.

SATISFACTION GUARANTEE

Funeral and cremation costs can at times e confusing. Often other funeral or cremation providers quote a low price, but not include your complete costs.