This information is for guidance at such time of my death. Preferences on certain subjects have been expressed, and unless changed by unforeseen circumstances, are desired.

    For (Full Name):

    Email:

    WHEN THE NEED ARISES, I DESIRE that BELL, LAMB AND TROTTER FUNERAL DIRECTORS LIMITED be contacted to conduct all necessary arrangements for my funeral. A copy of my own personal wishes expressed below is held at their office:

    Funeral Service to be held at:

    Celebrant:

    Yes

    Minister:

    Yes

    Cremation at:

    If Other, please specify:

    Burial at:

    If Other, please specify:

    Burial Plot No. / Ashes to be interred at:

    Notices in Newspapers:

    If Other, please specify:

    Before/After Service:

    Age in Newspaper: YesNo

    Mention of flowers:

    Donations to:

    Choice of Casket:

    Preference of Casket Flowers:

    If Other, please specify:

    Type/colour:

    RSA/Lodge/Clubs/Other Affiliations:

    Service Preferences

    Music/Hymns/Songs: YesNo

    Readings/Poems: YesNo

    Catering:

    If other, please specify:

    Clothing:

    Jewellery to remain:

    Jewellery to return:

    Funeral Account to:

    Name:

    Address:

    Prepaid: YesNo

    Amount:

    Date:

    Further details I would like observed:

    Details for registrar of Births, Deaths & Marriages

    Personal:

    Profession/Occupation:

    Date and place of birth:

    If born overseas:
    I have resided in New Zealand since

    Service Record: Service No:

    Rank:

    Regiment:

    Wartime Service:

    I am a Justice of the Peace,
    Registered Nurse or Title holder of:

    Next of Kin:

    Name:

    Address:

    Trustee/Executor:

    Name:

    Address:

    Parents:

    Father's Full Name:

    Father's Occupation:

    Mother's Full Maiden Name:

    Mother's Occupation:

    Mother's Marital Status:

    Marriage:

    Spouse's Full Name (Maiden):

    Spouse's Date of Birth:

    Date and Place of Marriage:

    Previous Marriage Details:

    Spouse's Full Name (Maiden):

    Spouse's Date of Birth:

    Date and Place of Marriage:

    Children:

    First Name and Date of Birth
    of Living Children:

    Other personal details:

    My Will is held by:

    Solicitor:

    Society/Club Memberships:

    Funeral Arrangements