A Death Has Occurred

Name: Considerate Cremation & Burial Services Inc.
Address: 1-52 Scott Street West, St. Catharines, Ontario, L2R 1C9
Telephone: 289-362-1144

Please call us immediately at 289-362-1144 if you currently require our services.

Having a Will certainly removes questions about who we are to take direction from when services are required. Please bring a copy of the Will so we are able to prove that we are taking direction from the proper person(s). We would need to take direction from the Executor or Executrix if there is an existing valid Will. The following form will provide the list of information that we are asked to gather by the Provincial Mandate for Death Registration along with a few details about your preferences for disposition (cremation, burial or entombment) and the level of service that you would like us to provide.

If you are completing this process in advance of a death, please do not go further on this page.

Simply click here to be re-directed to the pre-planning/pre-arranging page (Record My Final Wishes) .

Please do not simply complete this form without calling us to notify us of your immediate need.

Immediate Funeral Arrangements are for:

Please answer all sections the best of your ability as these questions make up the arrangements and are important and should be as accurate as possible. If you are not sure of a name or place simply mark it as Unknown.

Please bring a copy of the Will with you if one exists as we will ask to see it when making arrangements.

Full Legal Name - First Name:

Middle Name(s):

Last Name:

Please Indicate If There's A Preferred Name That Is Used; Such As Using Middle Name As Primary Name etc:

Free Text

Social Insurance Number will be required please call this in to us when you submit this form.

Day of Month

Year

City Of Birth:

Province/Territory of Birth:

Country Of Birth:

Address (include unit #):

City:

Province/Territory/Country:

Postal Code:

Date Of Death: (M/D/Y)

Location Of Death:

Address Of Location:

City Of Death:

Occupation: during working life (please do not reply: Retired)

Type Of Business:

Is This Person Currently Receiving Support Benefits?

If Yes, Please Identify From The List Below:

Pacemaker/Defibrillator Implanted?

Yes

Free Text

Marital Status (please indicate which best reflects current status)

Please indicate:

Single (Never Married)

Married (Separated=Married)

Widowed

Common Law

Divorced (we are still asked to gather former partner's name as per below)

Marriage Certificate / Declaration of Common Law Union

If Married, please be aware that we will require the Marriage Certificate to assist in applying for the CPP Survivor's Benefit.

If Common Law, please be aware that we will require a Declaration of Common Law Union to assist in applying for the CPP Survivor's Benefit. If you require a Declaration of Common Law Union we will provide one for this process.

Current/Last Partner

Middle(s):

Last (Maiden if Female):

Free Text

The following Parent's Information refers to the parents of the person for whom the arrangements are being made.

Father's First Name:

Father's Middle(s):

Father's Last Name:

Father's Place of Birth:

Mother's First Name:

Mother's Middle(s):

Mother's Maiden Name:

Mother's Place of Birth:

Is There A Will: (please know that we will ask to see it to verify we are taking direction from the Executor/Executrix)

Yes

Free Text

If there is a WILL, the Contact Person would be the person that's indicated in the WILL as the Executor/Executrix.

We require the name and details of the Executor/Executrix in this area of the form.

Contact Person: First Name

Middle(s)

Last

Is the person, named above, the Executor/Executrix? If there is no Will then there is no Executor/Executrix.

Yes

Relationship Of Contact Person: (Indicate ALL that apply)

Address (include unit#):

City:

Province/Territory:

Postal Code:

Residence Phone Number:

Cell Phone Number:

Email Address:

Death Notice Information: (please place a (D) after those predeceased)

Memorial Donations To Be Listed In Notice:

Hobbies/Clubs/Activities:

Would You Like To Include A Photo With The Notice? We Can Post Photos To Our Web Pages As Well At No Charge.

Yes - with publication of notice in newpaper(s)

Yes - please include on web pages (at no charge)

Church Membership:

Lodge/Union Membership:

Other Memberships:

Disposition Options:

Cremation: the cremated remains may be buried in an earth grave or placed in a columbarium wall (niche) at the cemetery or taken home.

Burial: placement of a casket into an earth grave either with or without a grave liner or vault.

Entombment: placement of a casket into mausoleum crypt at the cemetery.

Disposition:

Cremation

Burial

Entombment

Levels Of Service That We Offer:

Traditional Funeral: service with casket present to be followed by either burial or cremation.

Memorial Service: burial or cremation prior to structured service.

Celebration of Life Service: burial or cremation prior to a more casual service.

Visitation (Gathering): casket/urn may or may not be present (visitation only).

Graveside Service: service at cemetery with either casket or urn.

Immediate Cremation: basic cremation without any type of formal service.

If you have an idea for an option that's not listed above, please advise in the Miscellaneous Notes & Instructions area below and we will certainly assist in any way possible.

Level Of Service That You Would Like Us To Provide (check more than one if unsure):

Traditional Funeral

Memorial Service

Celebration of Life Service

Visitation (Gathering) - no service

Graveside Service

Immediate Cremation

Do You Own Cemetery Property?

Yes - Grave - for placement of a casket or an urn

Yes - Crypt - Mausoleum Wall - for placement of a casket

Yes - Niche - Columbarium Wall - for the placement of an urn

Name Of Cemetery:

Cemetery City:

Plot Owner:

Miscellaneous Notes & Instructions:

Preferred Method Of Contact (check all that apply):

Phone

Cell

The WILL & SIN (Social Insurance Number)

Please bring a copy of the Will with you if one exists as we will ask to see it when making arrangements.

Social Insurance Number will be required please call with this when you submit this form.

Please call us, 289-362-1144, after submitting this form if you are in need of services as a death has occured.

Considerate Cremation & Burial Services is proud to serve St. Catharines, Port Dalhousie, Thorold, Virgil, St. Davids, Queenston, Niagara-on-the-Lake, Niagara Falls, Chippawa, Stevensville, Fort Erie, Crystal Beach, Ridgeway, Port Colborne, Wainfleet, Wellandport, Welland, Pelham, Fonthill, Fenwick, Jordan, Vineland, Lincoln, West Lincoln, Beamsville, Grimsby, Smithville, Stoney Creek and all families in the entire Niagara Region.

A Death Has Occurred

Immediate Funeral Arrangements are for:

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