Pre-Planning On-line

Welcome to our pre-need information page. Our goal is to be helpful as you obtain information about your pre-arrangement decisions.

We believe if, when and where you pre-arrange is a personal decision, but these decisions should only be made after you have reviewed the most complete package of information available.

You will find on this web page a vital statistics form. If you complete it and E-mail it to us, we will put together a package of information that is tailored to your personal needs and wishes.

Some of the information available is on subjects such as Veterans Benefits, Social Security Benefits, Living Wills, Medical Power of Attorney, Organ Donation and various other topics that will be important to those who want decisions made to help eliminate unnecessary burdens on loved ones if an emergency should occur.

A few minutes of your time will open the door to information that will assist in making these decisions with confidence. We look forward to serving you.

QUESTION
Should I pre-arrange?

ANSWER
If you knew there would be a day your family would need you the most, would you plan to be there?

What is Funeral Pre-Plannng
Simply put it is planning your funeral, or the funeral of a loved one, in advance. The following form allows you to express the type of service, place of burial and many of the other details which must be managed during a funeral arrangement. This form also has much information that a family member may not have that is essential for the death certificate (e.g. social security number and mother's maiden name). You have the option to simply request your choices to be kept on file or you may choose to pay the cost in advance and save money by paying at today's prices.

Why Pre-Plan
"Pre-arranging" the funeral service establishes your wishes ahead of time. At the time of personal loss, time and attention should be paid to the emotional needs of family and loved ones... not to the details of arranging a funeral service. We help you plan a funeral ahead of time for yourself or a family member. We explain your options. Best of all, you can make choices with the freedom from the usual urgencies that are created when death occurs.

Pre-Paying ... A Popular Choice
Pre-Paying the funeral is an important part of pre-arrangement allowing you to pay for services at current prices. This provides protection from the rising cost of funerals and assures that your family will have adequate funds for your future service.

Other Benefits of Pre-Paying

  • Allows a payment schedule to be tailored to your budget.
  • Controls funeral costs by guaranteeing locked-in costs at today's prices that will never be more expensive to your survivors.
  • Provides financial protection and freedom from worry. Should your circumstances change; if you're sued, go bankrupt, need nursing home care or go on Medicare/Medicaid or another government program, your prearrangement plan is protected.

Should Death Occur Away From Home
Once your pre-arrangements have been recorded with us, all you need to do is carry identification that states Lietz-Fraze should be contacted in event of deaths. We will then handle all details and necessary arrangements, regardless of where death occurs.

Fill Out Our Pre-Planning Form

* indicates a required field

 

I am planning for: myself spouse mother father child other
other

Personal Information

* Your Name:

Gender:

 Male Female

Race:

 Hispanic Origin? Indian Descent

If Hispanic, indicate Mexican, Spanish, Puerto Rican, Cuban, etc.

If of Indian Descent, indicate tribe and percentage of tribe & how much percentage of other origin (i.e. 50% Navajo, 50% White)

Marital Status:

  Single Married Separated Divorced Widow
  Widower

Address:

City:

State:

County:

Zip:

Phone:

* E-mail:

How long lived in Arizona:

Lived in Lake Havasu City:

Date of Birth:

Place of Birth:

Fathers Name:
First, Middle, Last 

Mothers Maiden Name:
First, Middle, Last

Citizen of What Country:

Social Security Number:

Spouse’s Name:

Spouse’s Maiden Name:

Place of Marriage:

Date of Marriage:

Work/Education History

Education Level Completed:

 Elementary to Secondary (0-12)

Education Level Completed:

 College 1-4 or 5+

Last Occupation:

How Long:

Name of Last Employer:

City & State:

Kind of Business:

Military Service

Service Branch:

Wars Served In:

Serial Number:

Date Enlisted:

Date Discharged:

(If you would like us to keep your informtion on file, it would be beneficial to give us a copy of your discharge papers, so your loved ones will be honored with a flag)

Final Disposition

Preference for Final Disposition:

  Burial Cremation

Ground Internment:

  Burial Vault Concrete Liner

Mausoleum Entombment:

  Yes

Cremation with:

  Niche Entombment Home Memorial Service
  Scattering

If Burial or Inurnment, Name of Cemetery:

Location:

A

  Cemetery Crypt Niche None is owned at the above location

Special Instructions:

Funeral Preferences

I prefer My Funeral Service To Be:

  Public Private None

Place of Service:

  Chapel Church Cemetary None Other

Conclude Service at:

  Graveside Church Reception

Religious Denomination:

Place of Worship:

 Clergyman Elder Priest Rabbi     Name:

Preferred Casket Type:

 Copper Wood Steel Bronze

Memorial Service Instructions

Musical Selections To Be Played:

1.

2.

3.

Will Suppply CD/Tape:

 Yes

Favorite Bible Passgaes:

1.

2.

3.

Favorite Flowers:

1.

2.

Favorite Literature or Poems:

1.

2.

3.

Favorite Flower Color:

1.

2.

Person To Finalize Arrangements At Time Of Death

Name:

Relationship:

Address:

City & State:

Zip Code:

Phone Number:

E-mail:

 Yes I would like a free no obligation cost analysis and information on guaranteed funeral plans

 

 

Lietz-Fraze Funeral Home
21 Riviera Blvd.
Lake Havasu City, AZ 86403
928-855-4949
Fax: 928-855-8164
E-mail: contactus@lietz-frazefuneralhome.com

Visitor: 588873
 

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