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Through four generations we have been committed to creating meaningful services for the families of the Lancaster area.
Call 24 hours: (717) 394-4097
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You are here: Home / Pre-Arrangement Form (Online)

Pre-Arrangement Form (Online)

Please complete this form to the best of your ability. If you have questions prior to our contacting you please call 717-394-4097 and mention that you are completing pre-arrangements online.

  • MM slash DD slash YYYY
  • Vital Statistics (Basic Information)

    Please complete the fields below with the information of the person to whom the prearrangements are intended for. This information will be used to file the death certificate at the time of death and is kept in strict confidence. If you do not know the answer to any of the below questions please enter the word, 'Unknown' in the appropriate field.
  • MM slash DD slash YYYY
  • Discharge papers (DD-214) will be required to receive military death benefits. Please mail us a copy or scan and email to info@DeBordSnyder.com or bring to our office. (please do NOT send originals)
  • While many people have had many different occupations throughout their career, please choose the one that best represents the individual.
  • i.e. manufacturing, retail, medical, laborer, etc
  • Note: Higher education does NOT include technical, trade, or business schools.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Family Information

  • Children (oldest to youngest with spouse info and phone number)

    If children are deceased, please type "deceased" before the respective name.
  • Example: Mike (Sally) Jones. (717) 555-5555
  • Additional Notes

    please provide us with any other information that you feel is pertinent.
  • Person Completing This Form

    If choosing an option other than "myself" please provide your contact information below.

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Orange Street Location

Lancaster, PA & Area Weather

141 East Orange Street, PA 17602
March 27, 2023, 9:51 pm
Partly cloudy
Partly cloudy
46°F
sunrise: 6:57 am
sunset: 7:24 pm
 
Marietta Avenue Location

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DeBord-Snyder Funeral Home & Crematory, 141 East Orange Street, Lancaster, PA,17602, - Phone: (717) 394-4097 Email: info@debordsnyder.com
2024 Marietta Avenue, Lancaster, PA,17603, - Phone: (717) 394-4097 Email: info@debordsnyder.com

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