Veterans – Step 2

Address: 2024 Marietta Avenue, Lancaster, PA, 17603, US
Telephone: (717) 273-6283

Online Arrangement Form - Veterans

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Information Required to File a Death Certificate
Please complete the fields below. This information is only used for filing a death certificate and is kept in strict confidence.
Person Making Arrangements (Contact Person)
Note: the person making arrangements will be listed as the "informant" on the Death Certificate. The "informant” is simply the person providing the decedent's personal information. Normally this person is the "next of kin" such as: son, daughter, spouse, or other relative; or executor or attorney for estate.
First Name of Contact Person
Middle Name of Contact Person
Last Name of Contact Person
Phone Number of Contact Person
Contact Person's Relationship to Deceased
Deceased Person's Information
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's First Name
Decedent's Middle Name
Decedent's Last Name
Decedent's Social Security Number
Decedent's Date of Death
Date Format: MM slash DD slash YYYY
Decedent's Place of Death
Street Address City State ZIP Code
Boro or Twp Where Death Occured
County Where Death Occured
Decedent's Residence (Where they lived most of the time)
Street Address City State ZIP Code
Decedent's Boro or Twp of Residence
Decedent's County of Residence
Decedent's Date of Birth
Date Format: MM slash DD slash YYYY
Decedent's Age
Date Format: MM slash DD slash YYYY
Decedent's Birthplace: (City)
Decedent's Birthplace: (State)
Decedent's Birthplace: (County)
Decedent's Birthplace: (Country)
Was the Decedent a U.S. Citizen
- Yes
- No
Sex of Decedent
Decedent's Race
Decedent's Marital Status
Name of Decedent's Spouse (include maiden name, if wife)
- Check if Decedent's Spouse is Deceased
Was the Decedent In the Armed Forces?
Deceased individual's discharge papers (DD-214) will be required to receive military death benefits. Please mail us a copy or scan and email to info@LancasterCremations.com (please do NOT send originals)
Decedent's Usual Occupation
While many individual's have had many different occupations, please choose the one that would best represent the decedent.
Decedent's Kind of Business/Industry
i.e. manufacturing, retail, medical, laborer, etc
Decedent's Education (highest completed) Elementary & Primary (0-12)
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's Higher Education
Note: Higher education does NOT include technical, trade, or business schools.
Does the Decedent Have a Pacemaker?
- Yes
- No
- Not Sure
Decedent's Father's First Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's Father's Middle Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's Father's Last Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
- check if decedent's father is deceased
Decedent's Mother's First Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's Mother's Middle Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's Mother's Last Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field.
Decedent's Mother's Maiden (last) Name
Legal forms require this information. If you do not know the answer to any of the below questions please enter the word "Unknown" in the appropriate field..
- check if decedent's mother is deceased
Please Choose One of the Following Options
- Hold Cremated Remains for Pick-up
- Deliver to Cemetery for Graveside Service
Cemetery Information
Cemetery Name Where Cremated Remains Will Be Buried
Cemetery Address
Street Address City State ZIP Code
I want Cremation Services of Lancaster to Provide Clergy
- Yes
- No
- Not Sure
Decedent's Denomination
If Answered "No" to Above Quetsions, Provide Decedent's Clergy's Name
First Last
Decedent's Minister's Phone Number
I Would Like Military Honors at Cemetery (Flag Folding Detail and Taps)
- Yes
- No
Decedent's Children (oldest to youngest with spouse info and phone number)
If children are deceased, please type "deceased" before the respective name.
First (Spouse) Last. Phone number
Example: Mike (Sally) Jones. (717) 555-5555
Additional Notes
Additional Notes (optional)
please provide us with any other information that you feel is pertinent.

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Veterans – Step 2

Online Arrangement Form - Veterans

Information Required to File a Death Certificate

Person Making Arrangements (Contact Person)

Deceased Person's Information

Cemetery Information

Decedent's Children (oldest to youngest with spouse info and phone number)

Additional Notes

No Hidden Fee Guarantee

Accepted Payment Methods

Satisfaction Guarantee