Dimon Funeral Homes, Inc.

Pre-Arrangement is the planning of funeral service details in advance of need. Pre-Arrangement is a prudent step in overall estate planning. It is an additional means of protection for the family and loved ones. Pre-Arrangement will allow you to:

Have peace of mind knowing your loved ones will be spared making difficult decisions at a time of loss Shelter funds from estate taxes without jeopardizing your social security or Medicare Freeze the costs at today's prices Ensure your wishes are carried out.

Pre-Arrangements can be completely funded, partially funded, or non-funded. Only the completely funded pre-arrangement will freeze the funeral costs. Any funds accumulated by the partial funding will be applied to the costs of the funeral at the time of death. Non-funded prearrangements are merely the recording and filing of service details.

If you would like us to start a pre-arrangement, please review and fill out our pre-planning form as completely as possible. We will then contact you to discuss your options.

Personal Information

First Name*
Middle Name
Last Name*
Address 1*
Address 2
City*
County*
State*
Zip/Postal Code*

Contact Information

Phone Number*	() -
Email Address

Vital Statistics

Marital Status
Social Security #
Date of Birth
Place of Birth
Spouse's Name
Spouse's Maiden Name
Date of Marriage
Place of Marriage
Father's Name
Mother's Name
Mother's Maiden Name

Funeral Service Info

Place of Service
Funeral Home
Address
Phone
Place of Visitation
Religious Denomination
Place of Worship
Lodge / Union
Person in Charge of Final Arrangements

Other Instructions

Please list any other instructions you may have:

Options

Please select one of the options below:
	Send information about pre-arrangement Contact me to set an appointment Please keep my information on file