Adams Funeral Home, serving the communities of Crothersville, Austin and Scottsburg in Jackson and Scott County in Indiana.
Adams Funeral Home, serving the communities of Crothersville, Austin and Scottsburg in Jackson and Scott County in Indiana.
Our Services : Vital Statistics
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Mark & Leslie Adams - Funeral Directors and Embalmers
Record Your Statistical Information

Facing the loss of a loved one is perhaps the most difficult event we all face. You can make it easier by recording your own personal information and preferences. We will keep this information on file and you may add to it, update it, or come in and complete your pre-planning at your convenience.

Record the statistical information about yourself and your family so that your loved ones will not face this painful task while they are grieving. Spending 5-10 minutes now can greatly reduce the stress on your loved ones in the event of your loss.

General Information

First Name
 Middle Name
 Last (Maiden) Name
Address
 Phone
 Social Security Number
City
 State
 Zip
Place of Birth (City)
 Place of Birth (State)
 Date of Birth
Email
    

Family Information

Spouse    
Marital Status

 Date of Marriage
Place of Marriage
First Name
Middle Name
Last or Maiden Name
Father    
First Name
Middle Name
Last Name
Mother    
First Name
Middle Name
Maiden Name

Demographics

Gender

 Education

Occupation

Occupation Status

Type of Business/Occupation

Church

Church Affiliation
Clergy
Cemetery

Next of Kin or Person Responsible for Final Affairs

Name
 Social Security Number
Address (City, State, Zip)
 Phone Number (Including Area Code)

Military Experience

Veteran
 Branch of Service

Surviving Relatives

Relationship Name City, State

Family Members Who Have Passed Away

Relationship Name City, State

Number Of:

Grandchildren
 Great Grandchildren
Great-Great Grandchildren

Comments or Special Information:


Adams Funeral Home

© 2002-2006 Adams Funeral Home

Adams Funeral Home
110 East Howard Street . Crothersville, IN 47229 . Phone: (812) 793.2571
Email: Adams@AdamsFuneralHomeOnline.com