Online Arrangement

Online Arrangement Form

One of the most caring things you can do for your family is to leave detailed information in keeping with your ideals.

Making arrangements at the time of loss is extremely difficult for those left behind. When most of the decisions have been made, it spares uncertainty and confusion at a time when emotional stress may make decisions difficult.

Would it be better in your situation to plan ahead, calmly and sensibly, when you are in a normal mental and physical state, when you have full ability to reason, and when you are able to discuss arrangements with your family?

You may file vital statistics and preferred information with us online by filling in the form on this page.

* Indicates required field

Full Name: *

First

Last

Telephone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Date of Birth (MM/DD/YYYY) *

City of Birth / Province of Birth *

Father's Name *

Mother's Name *

Father's City of Birth *

Spouse's Name *

Spouse's Maiden Name *

Your Occupation *

Business Type *

Mother's City of Birth *

Mother's Maiden Name *

Church Membership *

Lodge or Union Name *

Veteran *

Branch of Service *

Serial Number *

Date Enlisted (MM/DD/YYYY) *

Date of Discharge (MM/DD/YYYY) *

Rank at Discharge *

Location of a Copy of Discharge *

Time of Military Service *

Name of Cemetery *

Cemetery Location *

The cemetery property is in the name of *

Miscellaneous Notes and Instructions *

Please select one of the following *

Comment *

Submit

* The amount may change as several crematoriums may be used and charges can vary. If the transfer is from a residence
or a facility that requires two people the charge for the transfer will be an additional $125.00. Prices effective April 28, 2025.

© 2025 A Basic Service (A Division of Humphrey Funeral Home A.W. Miles - Newbigging Chapel Limited). All Rights Reserved.