Rebold Rosenacker & Sexton Funeral Home

Many people do not understand the importance of a pre-planning a service. Take a moment and think if a pre-planned funeral service would spare your family additional stress and burdens associated with your death. We believe the best way is to listen to your concerns and provide the choices you request. Whether you have questions concerning the entire funeral service, cemetery requirements, government or insurance benefits, our staff is available to help you with these issues. By making decisions in advance, which will be more difficult later, you can provide peace of mind to yourself and your family--knowing that everything is taken care of. Please take a few minutes to complete our on-line pre-need form. For more detailed information about funeral planning, visit www.caregivers-fhs.org and refer to the funeral planning information.

Your Full Name:
Your Email Address:
Your Maiden Name:
Street/Mailing Address:
City:
State:
Date of Birth:
Place of Birth:
Social Security Number:
Spouses Name:
Spouse Survived? Yes No
Marital Status:
Date of Marriage:
Place of Marriage:
Names of Previous Spouses:
Names of Parents:
Address of Parents (if still living):
Names of Children:
Addresses and Phone numbers of Children:
Names of Brothers and Sisters:
Addresses and Phone numbers of Brothers and Sisters:
Names of other friends and relatives who should be notified:
Addresses and Phone numbers of other friends and relatives:
Occupation:
Names of present and previous employers:
Addresses and Phone numbers of present and previous employers:

If you are a veteran
Date of enlistment:
Place of enlistment:
Date of discharge:
Place of discharge:
Rank:
Service Numbers:
Organization or outfit:
Commendations received:
Location of discharge papers:
Flag desired to drape casket:

Religious affiliation:
Professional and fraternal organization memberships:
Education (list schools attended and dates of any degrees or honors received):
Names of newspapers for obituary:
Organ Donation (list of authorized card and anyone who should be notified):
Funeral director or funeral home you prefer:
Clergyperson or anyone else you would like to officiate:
Funeral Service Location:
Visitation instructions:
Music, hymns or readings you would prefer during your service:
Memorial Donations you would like in your memory:
Names and Addresses and Phone Numbers of casket bearers:
Cemetery Name:
Address and location of cemetery property (include lot and grave number):
Casket and/or vault preference:
If you wish to be cremated, include disposition preference:
Location of will:
The name of the executor of your estate:
Address and phone number of the executor of your estate:
Attorney's name:
Attorney's address and phone number:
Insurance company name and policy numbers:
Location of insurance policies:
Any additional instructions:

Staff & Facilities - Obituaries - Services - Pre-Need - Links - Contact Us

Rebold, Rosenacker & Sexton Funeral Home
3700 Glenmore Avenue, Cincinnati, Ohio 45211-0280
Office: 513-661-6200 · Fax: 513-661-7286
Toll Free: 1-877-REBOLD-1
email: info@rebold.com