Vital Statistics Form

Vital Statistics Form


Planning is about making your wishes known and we've created this simple online form to assist you. You may fill out as much or as little as you wish, but we do need your basic contact information so we can follow up with you to get any additional information we may need to complete your arrangements.

If you have any questions or would like assistance with this form, please call 
(254) 435-2792.

Online Preplanning Form

Your Information

 

Personal Information of Deceased

 

The Deceased's Family, Work, & Education

Family Information

Additional Family Members

Education History

Work History

Military Service Information

The following information is only required if you selected "yes"

Visit www.prepaidfunerals.texas.gov for information relating to the purchase of pre-need funeral contracts including descriptions of the trust and insurance funding options available under state law.

All complaints must be in writing. Concerning the Prepaid Contract: Texas Department of Banking, 2601 North Lamar Boulevard, Austin, Texas 78705; 1-877/276-5554 (toll free); www.dob.texas.gov.