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Making Funeral Arrangements

When someone dies, we are available to help you 24 hours a day. We'll arrange for a time that's convenient for you, to make arrangements for services according to your wishes. We'll come to your home or you may come to the funeral home, whichever is more comfortable for you.

The form below lists some of the basic information that will be used for both the obituary and the legal documents that are required pertaining to a death.
 

Information of the person filling out this formName 

Address 

Phone Number 

Email 

Information about the deceased

Name2 

Address2 

SSN 

Date of Birth 

Place of Birth 

Father's Name 

Mother's Maiden Name 

Marital Status:




Education 

Employment 

Veteran 

Religious Affiliation 

Organization Affiliations 

People Preceded in Death 

Survivors 

Type of Funeral Service 

Type of Disposition 

Name of Physician 

Address of Physician 

Phone Number of Physician 


 



 

 
 
 
Betz-Jastremski Funeral Homes | 568 Bennett Street , Luzerne, PA 18709 | Robert J. Jastremski, Supervisor
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