Biographical Record Form
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BIOGRAPHICAL INFORMATION REQUIRED
First Name
Middle Name
Last Name
Maiden Name
Social Security Number
Year Residing in Town of Residence Address
City
State
Zip
Town of Former Residence Address
City
State
Zip
Birthplace
Date of Birth
Age at Last Birthday
Name of Parents
Mother's Maiden Name
Ethnic Origin
Hispanic
Yes
No
Race
Marital Status
married
widowed
never married
divorced
Spouse's Name include maiden
Employment Status
Retired
Presently Employed
Usual Occupation
Employer
Length of Time Employed
Other Places of Employment you may want included in newspater notice
Survivors (include relationship, city and state of residence) Deceased members of the family
Education
Clubs/Organizations/Hobbies
VETERAN'S SERVICE RECORD
Most veteran's service information can be obtained from the
DD214 -(Discharge Papers)
Date & Place entered Service
Date & Place Discharged
Branch of Service
Rank at time of Discharge
Service Serial Number or Claim Number
CEMETERY/CREMATORY INFORMATION
Cemetery Name
Lot
Section Number
Date of Last Interment in Lot
CHURCH & CLERGY NAME INFORMATION
Church
Clergy Name
FLOWERS or Donations Requested
Address of charity
City
State
Zip
PALLBEARERS
CLOTHING
We always suggest a long sleeve dress with a modest neckline for the women and a suit for the man. Possibly something that they would wear to church or out to dinner. It should reflect needs of the individual. Please provide undergarments when possible. Shoes may be worn if desired but are not necessary.
PICTURE
A picture can be used in the newspaper with the obituary or it may be used for the hairdresser to reference
Sender's Name
Sender's e-mail
Sender's contact #
Route 44 at Greenville Common . Greenville, RI 02828 . (401) 949-0180 .
awfh@aol.com
© 2008 Anderson Winfield Funeral Home. All Rights Reserved.
Biographical Record Form
