Leo M. Bacha & Gaut-Bacha Funeral Homes

One of the most loving, caring things that an individual can do is to leave behind details and information in regard to Pre-Planning. The grief a family feels when they lose a loved one often makes arranging a funeral seem unbearable. You can eliminate this difficult and emotional task for your family by Pre-Planning your funeral, either with or without pre-funding.

Advantages of Pre-Planning your funeral arrangements.

Pre-Planning will express your wishes.
Pre-Planning relieves your family from making difficult decisions at a time of emergency.
Pre-Planning will give you and your family the security and satisfaction of knowing that all the arrangements have been planned and even paid for.

Important note… Before making any decisions, including the purchase of funeral merchandise (caskets and burial vaults) please contact your local Funeral Director. He or she is the professional who can help guide you through this most important process.

Select a location below to reveal a Pre-Need Planning Form for that location.

Leo M. Bacha Funeral Home, Inc.
Pre-Need Planning Form

Gaut-Bacha Funeral Home, Inc.
Pre-Need Planning Form

Leo M. Bacha Funeral Home Inc. Pre-Need Planning Form Personal Information
Name (First MI Last):
Marital Status:
Birth Date:		Birth Place:
Current Address:
City:		State:
Zip:		County:
Phone:
E-mail:
Spouse's Name:
Spouse's Maiden Name:
Marriage Date:		Marriage Place:
Father's Name:
Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:
Work/Education History
Education (0-12):		College 1-5+:
Occupation:
Business:		Company:
Military Record
Branch of Service:
Serial Number:
Date Enlisted:		Date Discharged:
Rank At Discharge:
Discharge On File At:
Copy of Discharge Papers:		Yes No
Name Of Wars:
Funeral Service Request
Place Of Service:
Funeral Home:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Newspaper Information (Please list family members)
Children:
Brothers/Sisters:
Number of Grandchildren:
Other significant relatives:
Special Instructions
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Clothing Preference:		My own Other
Disposition Request
I Prefer:
Cemetery:
Address:
Phone:
Section:
Last will and testament exists:		Yes No
Location:

Other Instructions
Memorials/Donations To Charity
Please select all that apply: Send information about pre-arrangement Contact me to set an appointment Please keep my information on file

Gaut-Bacha Funeral Home, Inc. Pre-Need Planning Form Personal Information
Name (First MI Last):
Marital Status:
Birth Date:		Birth Place:
Current Address:
City:		State:
Zip:		County:
Phone:
E-mail:
Spouse's Name:
Spouse's Maiden Name:
Marriage Date:		Marriage Place:
Father's Name:
Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:
Work/Education History
Education (0-12):		College 1-5+:
Occupation:
Business:		Company:
Military Record
Branch of Service:
Serial Number:
Date Enlisted:		Date Discharged:
Rank At Discharge:
Discharge On File At:
Copy of Discharge Papers:		Yes No
Name Of Wars:
Funeral Service Request
Place Of Service:
Funeral Home:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Newspaper Information (Please list family members)
Children:
Brothers/Sisters:
Number of Grandchildren:
Other significant relatives:
Special Instructions
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Clothing Preference:		My own Other
Disposition Request
I Prefer:
Cemetery:
Address:
Phone:
Section:
Last will and testament exists:		Yes No
Location:

Other Instructions
Memorials/Donations To Charity
Please select all that apply: Send information about pre-arrangement Contact me to set an appointment Please keep my information on file