Rochester Funeral Homes


Resource Guide


Funeral Planning Check List, Vital Statistics Form,
Floral Selection Guide, Vaults and Mausoleums,
Funeral Etiquette, Memorial Cards, Legal Issues

Planning Resources Main Menu

Vital Statistics

This information will be required to fill out the death certificate. You must be sure all information and spelling of names are correct. Death certificates currently cost $30.00 each and will be required for social security, insurance benefits, and other legal matters.

Name _______________________________________

Social Security Number ________________________

Address _____________________________________

City ______________________________, State ____ 

County_________________, Country ______________

Birth Date ___/___/___, Birth Place ______________

Armed Forces Serial Number ____________________


Name/Address of Employer _____________________


Education 1-12 ______ College 1-4 or 5+ ______

Name of Father_______________________________ 

Name of Mother (Maiden) ______________________


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