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Treviño Funeral Home Southmost
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Treviņo Funeral Home Southmost.
*Require fields

Person Completing this Form*:
Relationship*:
Email*:
 
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
Address:
(no P.O. Box)
City:
State:
Zip:
Date of Birth:
(mm/dd/yyyy)
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Degree:
Veteran: Yes No
Military Branch:
Dates of Service:
Occupation:
Spouse's Full Name:
(Wife's maiden name, if applicable)
Religious Affiliation/Congregation:
 
Family Member Information

Family Member #1

 
Funeral Arrangement Details
Person in charge of arrangements:
 
Place of service or gathering:
If Other, please specify:

 

Preference for final disposition:
If Other, please specify:
Cemetery:
Disposition of cremated body:
 

In the space provided below, please share any information that would be helpful in creating a meaningful service. (ie. favorite hobbies, places, music selections, poems, scripture, etc.)

Any final thoughts that should be shared?

 

Do you wish to be contacted to discuss the details
of these arrangements, cost or payment options? Yes No

If yes, how should we contact you:
Phone Number:

If no, we will keep this information on file until you or your surviving family requests it.

  security code
Enter Security Code:

 

NOTE:
Texas law requires sellers of prepaid funeral contracts to hold a permit issued by the Texas Department of Banking. For additional information regarding prepaid funeral contracts, go to the website located at: www.prepaidfunerals.texas.gov.

Rosalinda Rivera Martinez
Born: 7/3/1968
Died: 10/4/2017
Valentin Alvarado - Ibarra
Born: 4/22/1945
Died: 10/4/2017
Douglas Keene
Born: 10/28/1921
Died: 9/29/2017
Alberto Uvalle
Born: 6/28/1940
Died: 9/24/2017
Merced Renteria
Born: 9/4/1929
Died: 9/24/2017
Infant Duenez
Born: 9/20/2017
Died: 9/20/2017
Annie Coston
Born: 2/5/1948
Died: 9/20/2017
Jesus Martin Beltran
Born: 7/27/1958
Died: 9/13/2017
Noe Cortez
Born: 3/29/1964
Died: 9/8/2017

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Treviño Funeral Home Southmost | 1955 Southmost Road | Brownsville, TX 78521 | 956-542-2516
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