Adams Funeral Home, Inc.

We would like to take this opportunity to talk with you and answer any questions you may have about pre-arranging or pre-funding funeral services for you or your loved ones.

Our commitment is to answer any questions you may have, with no pressure to proceed any further than you wish. Many people begin simply by asking questions, some record their vital information and selections of service types and merchandise to be kept in a file at the funeral home.

This information saves their family from having to think or search at the time when the information will be needed for death certificates or obituaries. Some people include in their files the names and addresses of friends they would like to have notified and so of the copies of music they have chosen, which may be difficult to locate. Whatever the need, we are here to assist you and your family in making a difficult time a little easier.

PREFUNDING your funeral service is a growing trend among those who wish to relieve their families of the funeral strain that may be placed upon them when a death occurs.

Funeral Costs can be locked in at today’s prices, guarding against the inevitable effects of inflation.
Your family can have the assurance of knowing that you have selected and paid for the type of funeral service and merchandise (casket and outer burial container) in advance of the need. They can walk into the funeral home at the time of need and bring with them no money. It is already cared for.
You can set aside the money for your funeral expenses in a way that would protect it should you ever need Medicaid assistance for nursing home or other care. Many families have had extensive medical bills near the end of life that have used up assets. Prepayment assures your family the type of funeral service you have deemed appropriate.
Payment plans are available, some of which also provide the inflation proof guarantee. Under some circumstances, if the death occurs before the funeral plan is completed, the balance will be forgiven.
Prepayment does NOT lock you into the funeral home where the arrangements have been made and paid for. Monies paid to a funeral home are placed in your name in such a way that they are transferable to another funeral home should you move or choose to use another facility.

If you are ready to begin the Pre-Planning process,
please call Adams Funeral Home Inc. at 269-657-6347,
or complete the form below

Personal Information
Name (First MI Last):
Marital Status:
Birth Date:		Birth Place:
Current Address:
City:		State:
Zip:		County:
Phone:
E-mail:
Spouse's Name:
Spouse's Maiden Name:
Marriage Date:		Marriage Place:
Father's Name:
Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:
Work/Education History
Education (0-12):		College 1-5+:
Occupation:
Business:		Company:
Military Record
Branch of Service:
Serial Number:
Date Enlisted:		Date Discharged:
Rank At Discharge:
Discharge On File At:
Copy of Discharge Papers:		Yes No
Name Of Wars:
Funeral Service Request
Place Of Service:
Funeral Home:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Newspaper Information (Please list family members)
Children:
Brothers/Sisters:
Number of Grandchildren:
Other significant relatives:
Special Instructions
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Clothing Preference:		My own Other
Disposition Request
I Prefer:
Cemetery:
Address:
Phone:
Section:
Last will and testament exists:		Yes No
Location:

Other Instructions
Memorials/Donations To Charity
Please select all that apply: Send information about pre-arrangement Contact me to set an appointment Please keep my information on file