My Wishes Booklet

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The "My Wishes" step by step preplanning booklet is available at Lippert-Olson Funeral Home. For your convenience we have this version available for printing right from your own home. Please remember this is copyrighted so it is only for personal use.

My Wishes

A step by step booklet to assist

In planning your own funeral

Created by

Lippert-Olson Funeral Home

1132 Superior Avenue

Sheboygan, WI 53081

(920) 452-1481

This Booklet

Contains The

Personal Wishes

________________________

Funeral Home

One of the first decisions that need to be made when preplanning is to select your funeral home. Lippert-Olson Funeral Home’s staff is kind, compassionate, caring and knowledgeable. We can offer you options to help you reach a decision that is right for you. Our preplanning staff has earned the Certified Preplanning Consultant (CPC) designation which the National Funeral Directors Association (NFDA) awards individuals who meet their rigid standard of education and conduct. The CPC requirements include education, testing, continuing education and an oath of conduct. This is just another example of our commitment to you.

Our staff includes licensed funeral directors, a licensed beautician, a licensed preplanning specialist, a florist, several funeral assistants, and luncheon staff.

We have two distinctively different chapels we offer to families as well as the choice of having your ceremony at the church or cemetery chapel of your choice. We have experience in dealing with the details when the death occurs out of city or state and have helped numerous families coordinate and assist other funeral homes when death occurs here and the funeral is out of the area.

The Life Celebration Ceremony

(The Funeral)

The celebration of life is to acknowledge that a life has been lived and that he/she has touched many lives. It provides a time and place for mourning and the expression of grief. This is when the sorrows of one are shared by many. It is a time that encourages the affirmation of faith. This is one of the few times when love is given and not expected in return.

We offer several different ways that you or your loved one’s life can be celebrated and this is a brief explanation of those ways.

One option is a visitation with your loved one present to be viewed. This provides family and friends a needed opportunity to say their last goodbyes. It helps affirm the reality and finality of death. This option would necessitate preparations which would include embalming. The ceremony could be held at our funeral home, your church or cemetery chapel. This ceremony could be done with a closed casket and no viewing if desired. This option is available for those families that choose cremation for disposition. Other components of this ceremony could include floral tributes, pictures, register book, memory folders and items which provide memories (i.e. Dad’s fishing pole, Mom’s favorite knitting needles, etc.) of your loved one.

Another option is a Memorial Service where your loved one’s body would not be present. If your choice for disposition is cremation with no viewing you may choose to have the urn present with or without the cremated remains enclosed. This option would not necessitate preparation which would include embalming. The ceremony could be held at our funeral home, your church, a cemetery chapel, a park, a fraternal hall, a lodge or any other place where the public can gather. Other components of this ceremony could include floral tributes, pictures, register book, memory folders and items which provide memories (i.e. Dad’s fishing pole, Mom’s favorite knitting needles, etc.) of your loved one.

The last option would be a ceremony at the gravesite/crypt space. The urn or closed casket would be present. Friends and family would gather at the time of the ceremony. Floral tributes are often a part of this ceremony.

Disposition

The following options listed below do not preclude
having a visitation and/or funeral ceremony.

Burial
At the cemetery, there is an opening dug into the earth (commonly called a grave) and the casket is placed into the opening and then the grave is filled back in. Most cemeteries require the casket be placed into an outer burial receptacle. These receptacles are made of concrete or of various kinds of metals and provide a measure of protection against the weight of the earth compressing the casket and may also provide a measure of protection for the casket against the elements.

Cremation
The human remains are placed into a retort (located at the crematory) and the body is then subjected to intense heat and flames to reduce it to its natural elements (often referred to as cremated remains or ashes). Most crematories will require the remains to be placed into a rigid container for the health and safety of their employees.

Entombment
This is when the casket is taken to a mausoleum, the crypt space (this is the concrete chamber the casket is placed in) is opened and the casket is placed into the crypt and then the opening is resealed.

Body Donation
The human remains are transported to a medical school for the purpose of medical research and training. Usually arrangements with the medical school need to be completed before the death has occurred to be sure the person meets their criteria. Your funeral director must also be made aware of this at the time of death because it may affect his method of preparation. Please note, the medical colleges do have the right to reject people who do not meet their criteria, so you should always have an alternative plan.

Biographical Information

Items in Blue are needed for State of Wisconsin Documents

Name______________________________________________
First, Middle & Last

Address____________________________________________

City ________________________State______ Zip__________

Year moved to City____________________________________

Moved From_________________________________________

Birth Date __________________________________________

Birth Place__________________________________________

Social Security Number_______________________________

Marital Status________________________________________

Spouse's Name______________________________________
First, Middle, (Last Name Prior to any Marriage) Last Name

Spouse’s Social Security Number ______________________

Spouse’s Birth Date __________________________________

When Married________________________________________

Where Married_______________________________________

Father's Name ________________________________________
First, Middle & Last

Mother's Name ______________________________________
First, Middle, (Last Name Prior to any Marriage) Last Name

Military ServiceYes_________ No__________

Branch of Service_____________________________________

War(s)______________________________________________

Rank_______________________________________________

Where Served or Stationed______________________________

Discharge Papers on file at _____________________________

Veteran's Disability Yes_____ No ____

Education

Primary (1-12)_________ Secondary (College 1-6)_______

Children

(List oldest to youngest, please include spouse and list City & State of Residence)

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

Number of Grandchildren_______ Great-grandchildren________

Great-great-grandchildren___________

Names of Grandchildren & Great-grandchildren

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

Brothers & Sisters (List oldest to youngest, including spouse and list City & State of Residence)

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

Relatives who have preceded you in death to be listed in the obituary ___________________________________________________

___________________________________________________

___________________________________________________

Name of Person in Charge: ____________________________

Address____________________________________________

City/State/Zip________________________________________

Phone and Cell Phone _______________________________

Type of Service Selected:

Visitation in Evening-Funeral Ceremony Next Day____________

Visitation & Funeral Ceremony Same Day__________________

Memorial Ceremony___________________________________

Grave side/Crypt side Ceremony_________________________

No Ceremony/ Immediate Disposition _____________________

Schools & Colleges Attended____________________________

___________________________________________________

Current or Last Occupation____________________________

Current or Last Employer(s) _____________________________

___________________________________________________

Dates or Years Employed_______________________________

Date of Retirement____________________________________

Previous Employment__________________________________

___________________________________________________

Religious Affiliation____________________________________

Name of Church ______________________________________

Church Group(s)______________________________________

___________________________________________________
___________________________________________________

Membership in Clubs, Lodges, Fraternal Orders, Civic Groups, Unions, Professional Organizations, etc.

___________________________________________________

___________________________________________________

Hobbies and Other Interests_____________________________

___________________________________________________

___________________________________________________

Place of Service: Funeral Home________ Church________

Chapel________ Other ________

Name of Church/Chapel/Other___________________________

Type of Disposition: Burial _____ Entombment_______

Cremation_______ Body Donation________

Option if body donation is refused:________________________

Name & Location of Cemetery/Mausoleum_______________

___________________________________________________

Description of Lot or Mausoleum Space____________________

___________________________________________________

City/State of Cemetery or Mausoleum _____________________

___________________________________________________

If Cemetery Space is a family plot then please list family name
___________________________________________________

Comments (This space is provided for any additional items not covered above such as, musical selections, memorial funds to be established, special readings, additional newspapers for obituary placement, etc...)

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

Casket Selections

If you have chosen a ceremony with viewing, and/or burial or entombment is your choice of disposition, you will need to select a casket. You can choose from a variety of materials including woods, metals and other materials. The interiors vary and there are many different types of fabrics, colors and designs. We would be happy to help you find the selection that is right for you.

Describe your casket preference:

___________________________________________________________________________

Outer Burial Container/Urn Vault Selections

Most cemeteries have rules which require an outer burial container that the casket is to be placed in for burial. We can explain the cemetery requirements and also explain the choices available to you to meet those requirements. Some cemeteries require an urn vault when cremated remains are to be buried. We have several urn vaults available and will be glad to assist you with that selection.

Describe your outer burial container/urn vault preference:

_______________________________________________________________________________

Life Celebration Ceremony Details

The life celebrations of today have far more options available than the just the traditional services of years past. A more personal touch is often preferred in both traditional and contemporary ceremonies. This lends itself to a more relaxed and comforting atmosphere for everyone.

My ceremony should be held at:

___________________________________________________

___________________________________________________

I am requesting this person(s) lead the ceremony:

___________________________________________________

___________________________________________________

I would like a eulogy to be given by:

___________________________________________________

___________________________________________________

The following family members are to speak:

___________________________________________________

___________________________________________________

Favorite scriptures/Psalms, poems, etc. ___________________

___________________________________________________

___________________________________________________

I prefer the following music before and after the ceremony:

___________________________________________________

___________________________________________________

I request the following music be a part of the ceremony:

___________________________________________________

___________________________________________________

Vocalists, instrumentalists or name of CD’s for musical selections:

__________________________________________

___________________________________________________

Other instructions: ____________________________________

___________________________________________________

___________________________________________________

___________________________________________________

Clothing

We encourage individuals and families to select clothing that reflects their loved one. If Dad was never a suit and tie sort of guy then have him wear his favorite “I Love Fishing” sweatshirt and jeans or that lucky golf shirt. If mom never went anywhere without her dress ironed, her make just right and jewelry matching then that is the memory picture we wish to create. For Dad you may wish to bring in that putter that always took two strokes off his game or for Mom those knitting needles and yarn that magically came out of her purse when there was time to fill. This is your time to help create that comforting memory.

Describe the clothing that you wish to wear: ________________

___________________________________________________

___________________________________________________

Hair

A person’s hairstyle is as individual as their choice of clothing. Having photos will help us achieve that look.

Do you have a regular hairdresser that you wish to be contacted to style your hair?   Please give us their name and phone number.

___________________________________________________

___________________________________________________

Cosmetics

Make-up instructions: foundation color, lipstick color, eye shadow, blushes, etc.   While we may not use the specific items you bring in it does help us to see what colors and shades we need to use to match. __________________________________________________

___________________________________________________

___________________________________________________

Fingernail Polish Yes_______ No ________

Color of Polish ______________________________________

Other instructions:____________________________________

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

Your favorite aftershave or perfume is a familiar scent to the family that often is very comforting. The name of the aftershave or perfume is:

___________________________________________________

___________________________________________________

Jewelry

Jewelry is often worn for visitation/viewing and then removed before final disposition

Jewelry to be worn: ___________________________________

___________________________________________________

___________________________________________________

Jewelry to be removed before disposition:

___________________________________________________

___________________________________________________

Jewelry to returned to:_________________________________

___________________________________________________

Eye Glasses

We recommend that if you wear eye glasses regularly that you have them on during the visitation/viewing. It is one of those recognizable features that distinguish you. Most often we remove them just prior to closing the casket. We are a volunteer collection for the Lions Club and will gladly donate your eye glasses upon your behalf if requested.

Donate Eye Glasses:   Yes___ No___

Veteran’s Benefits

Any veteran whose discharge was other than dishonorable may be entitled to various benefits. These benefits are determined by the VA (Veteran’s Administration) but can include the following:

A United States Flag.

Military Honors at place of disposition which can include part or all of the following, Gun Salute, Sounding of Taps and Folding/Presentation of Flag.

A government furnished marker/headstone. Please note this does not include installation or any foundation requirements that cemeteries may have.

Interment in a Veteran’s Cemetery.

Possible interment in Arlington National Cemetery.

A Presidential Memorial Certificate (PMC) is an engraved paper certificate, signed by the current President, to honor the memory of honorably discharged deceased Veterans.

Other benefits would be decided on a case by case basis.

Would you like Military Honors: Yes_______ No _______

Check all requested: Gun Salute _____ Taps ________

Flag Folding and Presentation_______

Grave Markers/Monuments

There are a few things you need to consider before purchasing a grave marker. Some cemeteries limit the size, style, or type of marker they allow. Some cemeteries require a flat or flush marker, some cemeteries allow upright markers of a certain shape, size and design, and other cemeteries have no restrictions. Please note that requirements may change depending on the section of the cemetery that you are in. When people are buried on a family plot there is often a large monument which could allow for engraving on that marker. If you can’t determine if there is space for engraving you may contact any of the monument companies in the area who will go out to the cemetery, check the marker and advise you of your options.

I am being buried on a family plot with a marker already in place: Yes_________ No__________

I have purchased a marker from: _________________________

___________________________________________________

The marker is already set in the cemetery: Yes____ No____

Final engraving has been prepaid: Yes____ No____

Type of marker preferred: ______________________________

Special designs or inscriptions: __________________________

___________________________________________________

Memory Table

The memory table is usually set up for the visitation and for the ceremony. We encourage family members to bring in pictures, crafts, hobbies, newspaper clippings from your past and other special mementos of your life. You can include items you wish to have there and also encourage your family to share items they may have. This helps bring back those special memories and creates a personal atmosphere for family and friends. We also provide boards for creating photo collage and have easels available for displaying them and other large photos. Items you wish included:

___________________________________________________

Video Tributes

Our funeral home has the technology to make a video tribute which is a slide show of pictures which is then set to music and then made into a DVD. We recommend 30-50 photos for the best results. If you are interested in this please ask us for more details.

Flowers

Flowers at a funeral do several things, they make the room more comforting, add wonderful aromas and are one of the many ways people show love and caring for the deceased.

Family flowers are a choice as individual as the deceased they honor. The casket spray, wreath, cross, basket, heart, etc. can be created with many different types of flowers and have script with your relationship to the deceased. There is no “right” or “wrong” choices for your selections. We have many fine florists in Sheboygan. Our funeral home does offer an on staff floral designer so you can make your selections here during the arrangement conference.

Please describe your favorite flowers and what you would prefer:

_________________________________________________________________________

__________________________________________________________________________

Charities

People often list a memorial fund in their obituary. This is usually one or more charities that will receive the money that is given in honor of the deceased. You can list the charity or just establish it the person’s name and decide the recipient later. My choices for charities are:

____________________________________________________________________

Pallbearers

Active pallbearers assist in carrying the casket where as honorary pallbearers walk in front of the casket. Please note that when choosing active pallbearers they must be able to lift and carry weight of 50 lbs or more.

Active: Name Phone Number

___________________________________ ____________

Honorary: Name Phone Number

___________________________________ ____________

Obituary

At Lippert-Olson Funeral Home we often assist families in writing and place obituaries in the newspaper(s). We also recognize that families often have a talented writer who can do a far better job than we can by adding those touches that are unique to their loved one. We do have an obituary writting guide which takes you step by step to write an obituary. Newspapers do charge for placing obituaries in their newspapers and some charge considerably more than others. We encourage publishing a photo along with the obituary. You may bring in your photo and we will keep it in your file until it is needed.

Place my obituary in the following newspaper(s): ____________

___________________________________________________

Publish my photo with the obituary: Yes_______ No ______

Describe the photo to be used: __________________________

___________________________________________________

If you have already written your obituary we encourage you to enclose it in this booklet and/or send a copy of it to our funeral home.

People to Notify

In many instances the family is unaware of people who would like to be notified of a death.

Church/Clergy:

___________________________________________________

Attorney:

___________________________________________________

Insurance Agent:

___________________________________________________

Others:

___________________________________________________

Important Papers & Information

Important information listed below is often stored in a Safety Deposit Box. It is recommended that someone have copies of this for instant access. Never put funeral plans in your will. The will is usually read after the funeral so it would not help your family.

Location of the Will: _______________________________

_______________________________________________

Insurance Companies and Policy Numbers:____________

_______________________________________________

Bank Accounts: (Location and who is on the account)

________________________________________________

Safety Deposit Box:________________________________

________________________________________________

Stocks, Bonds, Investments: (Brokerage Firm or Agent)
________________________________________________

________________________________________________

Military Discharge Papers:______________________________

___________________________________________________

Note, sometimes discharge papers are on file with the Registrar of Deeds.

Location of Titles to Vehicles or Deeds: ____________________

___________________________________________________

Other Important Items that need someone should be aware of and the location:

__________________________________________________

Take some time to jot some simple messages to those you care about. If there are items you wish to give to someone, that doesn’t need to be in the will, mention them here. These can be lasting memories for those who receive them.

___________________________________________________

Write down things you would like to be remembered for. Mention places, events or people in your life that helped you become who you are.

___________________________________________________

Prefunding

We have professionals on staff to help you establish a funeral trust (which is depositing funds for the estimated funeral expenses). The funds deposited do remain in the person's name with the funeral home payable upon death. Funeral trusts should be set up to be a qualified exempt asset for SSI and MA/Title 19 programs. The two most common choices we use are insurance trusting or the Wisconsin Funeral Trust and both meet the qualifications.

Insurance Trusting: is when funds are used to purchase a life insurance policy. The policies usually have some growth which is nontaxable (No 1099 Earning Form is sent).

Wisconsin Funeral Trust: is when funds are deposited in an account with a Master Trust. Here in Wisconsin we are able to use the Wisconsin Funeral Director's Association Wisconsin Funeral Trust. These accounts earn interest at a rate often above the current rate of return paid by Certificates of Deposit at your local bank. There is a 1099 interest statement which is sent out annually.

Funeral trust with Lippert-Olson Funeral Home Yes___ No___

Alternative Funeral Funding _____________________________

___________________________________________________

Please note if you have alternative funding there will be a required amount due at time of arrangements.

Notes

________________________________________________

Declaration of Intent

I have given careful though and consideration to the choices I have made and outlined in this book. While I understand that this is not legally binding, and that ultimate decisions will be made by my family, and or other appropriate persons, based on the circumstances at the time of my death,

I respectfully request that my wishes be fulfilled to the fullest extent possible.

Date: _______________________________________________

Signed by:

___________________________________________________

Witnesses:

________________________ ______________________

Printed name Signature

________________________ ______________________

Printed name Signature