170 W. Sequim Bay Road Sequim, Washington 98382 Office (360) 683-1649 Fax (866) 458-4503
Statement of Funeral Goods and Services Selected *Charges are only for those items that you have selected or that are required. If you are required by law or by a cemetery to use any items, we will explain the reasons in writing below:
Deceased: ___
______________________
Date of Arrangements: _____
_________
Burial Plan Pricing Plan 3- Direct Burial WITHOUT Graveside Service
$____ 1190.00_______
*Pickup from place of death, death certificate completion, social security notification, delivery of casketed remains on MondayFriday between 8am – 5pm to a cemetery in the local service area. (This plan does not include a casket)
Plan 4- Direct Burial WITH Graveside Service
$____1,490.00________
*Pickup from place of death, death certificate completion, social security notification, delivery of casketed remains on MondayFriday between 8am – 5pm to a cemetery in local service area. (This plan does not include a casket)
Plan 5- Full Mortuary Service
$_____2,390.00_______
*Pickup from place of death, death certificate completion, social security notification, dressing, embalming, casketing, cosmetology, directing of services at the facility of your choice. Between 8am – 5pm Monday- Friday (This plan does not include a casket)
Plan 6- Forwarding Remains to another Funeral Home
$_____1,690.00_______
*Pickup from place of death, death certificate completion, social security notification, embalming, dressing, casketing, coordination with receiving funeral home, flight arrangements and delivery of the casketed remains in an air tray or combo unit as required by airlines. (Casket and air fare not included)
Total of Plan
$___________________ Merchandise
Casket Type: ________________________________________
$____________________
Sales Tax: 8.7% (on taxable items)
$____________________
Washington State Burial Fee
$__________8.00______
Dressing/Casketing/Cosmetology
$____________________
Memorial Service
$____________________
Death Certificates: _______ ($20 each)
$____________________
Other Merchandise
$____________________
Total Cost of Arrangements
$_________________