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:

Single
Married
Widowed
Divorced

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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