Funeral Arrangement - Shone & Shirley Nelson New Zealand

This information is for guidance at such time of my death. Preferences on certain subjects have been expressed, and unless changed by unforeseen circumstances, are desired.

WHEN THE NEED ARISES, I DESIRE

that SHONE & SHIRLEY FUNERAL DIRECTORS LIMITED
be contacted to conduct all necessary arrangements for my funeral. A copy of my own personal wishes expressed below is held at their office:

Funeral Service to be held at:

If Other, please specify:

Cremation at:

If Other, please specify:

Burial at:

If Other, please specify:

Burial Plot No. / Ashes to be interred at:

Notices in Newspapers:

Before/After Service:

Age in Newspaper:

Mention of flowers:

Donations to:

Choice of Casket:

Preference of Casket Flowers:

If Other, please specify:

Type/colour:

RSA/Lodge/Clubs/Other Affiliations:

Service Preferences

Catering:

If Other, please specify:

Clothing:

Jewellery to remain:

Jewellery to return:

Amount:

Date:

Further details I would like observed:

DETAILS FOR THE REGISTRAR OF BIRTHS, DEATHS & MARRIAGES

PERSONAL:

Profession/Occupation:

Date and place of birth:

If born overseas: I have resided in New Zealand since

Service Record: Service No:

Rank:

Regiment:

Wartime Service:

I am a Justice of the Peace, Registered Nurse or Title holder of:

NEXT OF KIN:

Name:

Address:

TRUSTEE/EXECUTOR:

Name:

Address:

PARENTS:

Father's Full Name:

Father's occupation:

Mother's Full Maiden Name:

Mother's Occupation:

Mother's Occupation:

Mother's Marital Status:

MARRIAGE:

Spouse's Full Name (Maiden):

Spouse's Date of Birth:

Date and Place of Marriage:

Previous Marriage Details:

Spouse's Full Name (Maiden):

Spouse's Date of Birth:

Date and Place of Marriage:

CHILDREN:

First Name and Date of Birth of Living Children:

OTHER PERSONAL DETAILS:

My Will is held by:

Solicitor:

Society/Club Memberships: