Name: Plan Online
Price: 1395 USD
Availability: InStock

Product Info

✔ Online arrangements.
✔ Professional basic services of the funeral directors and staff.
✔ Obtaining the cremation permit from the county in which the death occurred (Fees from the County Medical Examiner/Coroner are not included).
✔ Transfer of the deceased from the place of death to the funeral home.
✔ Our staff is available any time of the day or night.
✔ Submitting of Veteran Benefit Paperwork.
✔ Cremation at a licensed crematory.

What is the approximate weight of your loved one? *

Where is your loved one located? *

How would you like to receive the cremated remains? *

I would like assistance obtaining Certified Death Certificates. ($15 per copy) *

Middlesex Cremation offers the assistance to obtain a certified death certificate as an optional service. Families can obtain a certified death certificate directly from the county health department on their own. However, we are happy to obtain certified copies of the death certificate from the health department on your behalf and mail them to you.

Viewing *

Caskets / Alternative Containers

Please call us first and notify us that a death has occurred (978) 622-1234

We extend our deepest sympathies to you for your loss. Please call us first and notify us that a death has occurred. Completing this form does not notify us immediately. After you notify us, please proceed with your online arrangements.

There may be additional costs associated with the transportation of your loved one into our care. The cost, if applicable, is calculated based on the distance between the "Location of the deceased" and our facility. If the location of the deceased lies outside of the service area, the cost will be calculated in your cart. Please contact us with any additional questions.

Location of Deceased *

Location of your loved one for transportation into our care.

Information About the Person Completing This Form

First Name *

Last Name *

Phone Number *

E-mail *

Address *

Person for whom I am filing for:

Deceased Vital Statistics for Death Certificate

Prefix

First Name *

Middle Name

Last Name *

Gender

Social Security Number

Date of Birth *

MM - DD - YY

Date of Death *

MM - DD - YY

Information Form Options

I would prefer to provide as much information now as possible.

I would prefer to provide more details later.

City of Birth *

State of Birth

Marital Status

Full Legal Name of Spouse

Prefix

First Name *

Middle Name

Last Name *

Maiden Name (If Applicable)

Father's Full Name

Prefix

First Name *

Middle Name

Last Name *

Mother's Full Name

Prefix

First Name *

Middle Name

Last Name *

Maiden Name (If Applicable)

Other Information

Deceased's Address *

Social Security Number

Education

Occupation (most of life)

Business/Industry

Deceased of Hispanic Origin?

How many living adult children the deceased has?

How many living adult siblings the deceased has?

Mother's birthplace State/Province

Father's birthplace State/Province

Race

Veteran Information

If your family would like a flag provided by the federal government, please email a copy of an Honorable Discharge Form (DD-214) to simplycremationofga@gmail.com.

Was Deceased Ever In the US Armed Forces? *

Branch of Service *

Plan Online

Delivery

24/7 Support.

Online Payment.