Miller Mortuary

Here at Miller Mortuary, our goal is to serve our community. Most of the time that service is based around a tragic event is people's lives, but fortunately, there are instances where we can help before someone passes away. On this page, you will find a personal planning guide. This guide is designed to allow you to record all your vital statistics and important documents that will be needed in an emergency so that your family will not have the added worry of collecting and verifying these facts.

Preplanning for your funeral may be one of the most thoughtful ways of expressing your love for your family. If you would like to know more about finding your Peace of Mind, we can help.

Having your personal planning guide is easy; just follow these steps:

Press the Print button on your browser to send this information to your printer.
Fill out the form as complete as possible to ensure an accurate record
Visit with Miller Mortuary about preplanning your funeral to settle your and your family's Peace of Mind.
Inform your family of your prearrangement plans.

VITAL STATISTICS AND HISTORICAL DATA FOR

E-mail Address:

Full Name:

Address:

City:

State:

Zip:

Phone:

Social Security Number:

Date of Birth:

Father:

Mother (& Maiden name):

Birthplace - State or Foreign Country:

Education:

Usual Occupation:

Employed By (or retired from):

Never Married

Single

Married

Widowed

Divorced

Spouse of:

Date of Marriage:

Place of Marriage:

Maiden Name:

Are You a Veteran: Yes No

Name of War:

Branch of Service:

Date Enlisted:

Where:

Date Discharged:

Where:

Service #:

Rank:

Claim #:

Name of Cemetery:

City:

State:

Lot in Name of:

Lot:

Spaces:

Section:

Church Preference:

Clergyman:

I wish the service to be held at:

Funeral Home:

Church:

Graveside:

RELATIVES AND FRIENDS

For help or advice in settling my affairs, and in making arrangements for the future, please notify:

Name:

Relationship:

City and State:

Name:

Relationship:

City and State:

Name:

Relationship:

City and State:

Name:

Relationship:

City and State:

I Own Burial Property At:

I have a Prearranged Funeral Service: Yes No

If, Yes, Name of Mortuary:

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