Burial Contract
170 W. Sequim Bay Road Sequim, Washington 98382 Office (360) 683-1649 Fax (866) 458-4503
Burial Contract
*Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery to use any specific items, we will explain the reasons in writing below. If casket is not selected by the time of signing this contract, the price will be reflected on a Sales of Goods form (separate)
Deceased: _____________________________
Purchaser: _______________________________
Purchaser Address: ______________________________
Telephone: _______________________________
Date of Death: _________________________
Date of Arrangements: _____________________
I authorize Linde-Price Funeral Services, to proceed with burial arrangements and I agree to pay Linde-Price Funeral Services, $_____________________ prior to the burial process. *I hereby acknowledge that I have legal right to arrange the final services for the deceased, and I authorize Linde-Price Funeral Services to perform the burial services, furnish goods, and incur outside charges specific on this statement. I acknowledge that I have received a General Merchandise Price List prior to our discussion of prices and I have retained a price list for my records. Initials: ______________
Name (Printed): _____________________________________________________________________
Signature: __________________________________________________________________________ *Disclosures: Reason for Embalming: ___________________________________________________
Refrigeration is required in lieu of embalming.
Funeral Director Signature: _____________________________________________________________ Date: _____________________________
Time: ___________________________________
Burial Contract
*Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery to use any specific items, we will explain the reasons in writing below. If casket is not selected by the time of signing this contract, the price will be reflected on a Sales of Goods form (separate)
Deceased: _____________________________
Purchaser: _______________________________
Purchaser Address: ______________________________
Telephone: _______________________________
Date of Death: _________________________
Date of Arrangements: _____________________
I authorize Linde-Price Funeral Services, to proceed with burial arrangements and I agree to pay Linde-Price Funeral Services, $_____________________ prior to the burial process. *I hereby acknowledge that I have legal right to arrange the final services for the deceased, and I authorize Linde-Price Funeral Services to perform the burial services, furnish goods, and incur outside charges specific on this statement. I acknowledge that I have received a General Merchandise Price List prior to our discussion of prices and I have retained a price list for my records. Initials: ______________
Name (Printed): _____________________________________________________________________
Signature: __________________________________________________________________________ *Disclosures: Reason for Embalming: ___________________________________________________
Refrigeration is required in lieu of embalming.
Funeral Director Signature: _____________________________________________________________ Date: _____________________________
Time: ___________________________________
