Obituary Report Template Page 2
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2Survivors
Please list spouse, children, parents, brothers and sisters, grandparents, grandchildren and great-
grandchildren, etc.
Full name
Relationship
Place of Residence
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Preceded in death
Please list those relatives who preceded in death
Full name
Relationship
Place of Residence
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Services
Visitation or viewing time, date and location________________________________________________________
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Type of service(s), time, date and place____________________________________________________________
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Officiant and place of residence__________________________________________________________________
Memorial donations____________________________________________________________________________
Name of funeral home__________________________________________________________________________
Family contact__________________________________________________ Phone_________________________
Submitted by____________________________________________________ Phone________________________
Deadline for submitting information/photo is noon on Monday prior to publication.
Information is subject to editing. To ensure publication in its entirety,
please contact our office for rate information.
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Parent category: Life