PRE-PLANNING

Reasons for pre-planning:

Put your affairs in order
Plan what you want
Peace of mind
Remove the burden from your family

Reasons for pre-paying:

Fix the costs
Pay over time
Money is 100% escrowed in an account owned by you and your family
Remove financial budget from your family
It’s Safe
It’s Responsible
It’s Easy

Print Form: If you prefer, you may print and complete this form (below) and mail to:

Dressler's Jewish Funeral Care
P.O. Box 80647
Atlanta, Georgia 30366

Please complete all steps below. (*required fields)

1. Your Information:

First Name*

Last Name*

E-Mail*

Address Line 1

Address Line 2

City

State

Zip Code

Mobile/Landline*

Mobile/Landline

2. Who is this Pre-Arrangement for?

Myself Spouse Father Mother Brother Sister Other

Type info for other

3. Personal Information for whom funeral is being planned

Name:

First Name*

Middle Name

Last Name*

Nickname

Hebrew Name

Maiden Name

Address:

Address Line 1

Address Line 2

City

State

Zip Code

County

Inside City Limits? Yes No

About:

Gender: Male Female

Date of Birth

City and State of Birth

Spouse:

Pre-Arranged Spouse's Name

Spouse's Maiden Name

(If Female)

Spouse's Date of Death

If Spouse is Deceased

Parents: Father :

Father's First Name

If you don't know, please type "Unknown"

Father's Middle Name

Father's Last Name

If you don't know, please type "Unknown"

Father's Hebrew Name

If you don't know, please type "Unknown"

Living Deceased

Parents: Mother :

Mother's First Name

If you don't know, please type "Unknown"

Mother's Middle Name

Mother's Maiden Name

If you don't know, please type "Unknown"

Mother's Hebrew Name

If you don't know, please type "Unknown"

Living Deceased

Occupation:

Occupation

State does not allow Retired as occupation

Kind of Business worked in

Name of Companies worked for

Education:

Immediate Family: Please enter information below:

Children (Please list City/State of Residence)

Brothers/Sisters (Please list City/State of Residence)

Grandchildren (Please list City/State of Residence)

Great Grandchildren (Please list City/State of Residence)

Other significant family or friends (Please list City/State of Residence)

5. Cemetery Information:

(Note: we handle funerals anywhere around the country, Israel, and other countries. )

I need help with cemetery plots:

Yes No

I already own plots:

Yes No I Don't Know

Do you own a graveliner or vault?:

Yes No I Don't Know

If Yes, which section

Other Preference

7. Military Preferences:

A copy of the DD214 for the deceased is required for a veteran’s burial

Veteran of US Armed Forces?:

Yes No

If Yes, please select branch

Do you want:

US Flag (if Veteran)

Military Honors

Inter at a VA Cemetery

8. Casket Selection:

View Caskets Here

9. Other Details:

Will you need help with a grave marker/monument?:

Yes No Let's Discuss Later

Will a passenger limousine (for family) be helpful ?:

Yes No Let's Discuss Later

Death Certificates:

Certified death certificates are needed for the following:
Social Security (if spouse is living); real estate, automobile, or anything you transfer title to (even if joint ownership); life insurance policy; accounts exclusivley in the deceased name; probate a will; stocks and bonds

My estimate of the number of certified death certificates is:

10. Communication with Dressler’s Jewish Funeral Care:

I would like to discuss pre-payment:

Yes No

E-mail estimated cost to:

Call me to set up an appointment: I will contact you when I am ready:

Print The Form

Please Note: Form can not be printed after submitting the form. Please print the form before submitting the form..