Croswell Funeral Home Online Info Sheet 1 Croswell Funeral Home Arrangement Form Croswell Funeral Home Arrangement Form Date of Death FULL NAME INCLUDE MAIDEN Marital Status (Select)MarriedDivorcedNever MarriedWidowed Date of birth sex Male Female age Spouces name include maiden Military Service Branch, war, induction date, discharge date , rank ,service number Place of Death Street and number Education , Highest Degree Example : grade 9-12, no HS Diploma, HS Diploma or GED, Some College No Degree, Associates, Bacelors Race Residence full address (Street number apt. , city, State and Zip Place of Birth City and State Occupation: Social Security Number Industry Father's Full Name at Birth Father's State of Birth Mother's Name Include Name at Birth Mother's State of Birth Place of Interment Name of Informant Phone Number Address of Informant Email Address * INFORMANT RELATIONSHIP (Select)HUSBANDWIFEDAUGHTERSONBROTHERSISTEROTHER DESCRIBE OTHER IN NEXT FIELD OTHER INFORMANT DESCRIPTION If you are human, leave this field blank.