Funeral Checklist
No Funeral, No Flowers. No Fuss. Telephone: 1300 854 971 Information Statement page 2
First Marriage (provide details of any marriage)
Full name of spouse at
marriage:
Age at marriage:
years
Place of Marriage:
Second Marri age
Full name of spouse at
marriage:
Age at marriage:
Place of Marriage:
Any subsequent marriages:
YES
(Please indicate here and provide details in the space overleaf)
De-Facto Relationship (at time of Death)
Age at commencement:
years
Partner's given names :
Partner's surname at
commencement of relationship:
Children's Details (all offspring and legally adopted children)
Full Name Date of Birth
Child 1:
Child 2:
Child 3:
Child 4:
Any subsequent
children:
YES
(Please indicate here and provide details in the space overleaf)
Next of Kin Det ails
Name Address Telephone
Other Details
(Requi red for Health Department Forms)
Executor details:
Usual Docto r's nam e
and address:
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