Vital Statistics

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of birth
Date Format: MM slash DD slash YYYY
City and State of birth
City State / Province / Region Country
Social Security
Citizenship
Sex
- Male
- Female
Race
Marital Status
Spouse
First Last
Level of Education
Occupation (you can’t use retired-you can use homemaker if applicable)
Military Service
- Yes
- No
If yes what years and branch of service?
Date of Service
Date Format: MM slash DD slash YYYY
Their father’s name & mother’s maiden name.
NEXT OF KIN (Closest Surviving Family Member)
Name
First Last
Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
DISPOSITION
Cemetery
Burial Next to
Who died on
Date Format: MM slash DD slash YYYY

NEXT OF KIN (Closest Surviving Family Member)