Information for the person the plan is for Full Name:* First Middle Last (As It Appears On Social Security Card)Maiden NameSocial Security NumberPhone:*Email: Address:* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Inside City Limits:YesNoSex:*Race:*Marital Status:*MarriedSingleWidowedName of Spouse: First Middle Last Spouse Maiden Name:Next of Kin: First Middle Last Relation:Father's Name: First Middle Last Mothers's Name: First Middle Last Education/WorkHighest Level of Education:Occupation:(Prior to Retirement)Industry:Military ServiceMilitary ServiceYesNoBranch of Service:Funeral Home will need to have a copy of the discharge or separation papers form DD-214.Burial or Cremation?BurialCremation