Biographical Record Form Biographical Record Online Submission Form 1Biographical2Family3Occupation4Education5Survivors6Veteran7Cemetery8Church & Clergy Name9Other The form is divided into 9 sections as above: You can lick on "Next" or "Previous" to proceed to the next/previous section. After completing the info, you can click "Submit" at the end of the final step. You can also click on "Save & Continue Later" to save your progress and come back within the next 30 days to complete the form. Once you click the "Save & Continue", our system will provide a link for you to use. At the same time, you can enter your email to receive the link information. You can also give us a call at (401) 949-0180 for any questions. Biographical Information RequiredFirst Name Middle Name Last Name Maiden Name Social Security Number US War VeteranYesNoResidence Address Years Residing City State Zip Mailing Address City State Zip Town of Former Residence Years Residing Date of Birth MM slash DD slash YYYY Birthplace Family InformationFather's First Name Father's Middle Name Father's Last Name Father's Birthplace Mother's Last Name Mother's Middle Name Mother's First Name Mother's Maiden Name Mother's Birthplace Ethnic Origin HispanicYesNoRace Marital StatusMarriedWidowedNever MarriedDivorcedSpouse's First Name Spouse's Middle Name Spouse's Last Name Spouse's Maiden Name Usual OccupationGive kind of work done during most of working life. DO NOT use retiredOccupation Employer Years Employed Other Places of Employment you may want included in newspaper notice EducationDecedent's EducationWrite in one of the following choices that corresponds to the highest level of education that the decedent completed. Doctorate or Professional Degree Master's Degree Bachelor's Degree Associate Degree Some College, but no degree High School Diploma GED If the decedent did not graduate high school, put the highest grade completed SurvivorsListNameRelationshipCity & State of Residence Add Remove*Please click the + icon above to add more survivorsPREDECEASED FAMILY MEMBERS - Name only requiredClubs/Organizations/Hobbies Veteran's Service RecordVeteran's service information can be obtained from the DD 214 (Discharge Papers). A DD 214 is a REQUIRED document for ANY military honors or burial.Date & Place entered Service Date & Place Discharged Branch of Service Rank at time of Discharge Service Serial Number or Claim Number Cemetery InformationCemetery Name Lot Section Number Date of Last Interment in Lot MM slash DD slash YYYY Church & Clergy Name InformationChurch Clergy Name Name of Charity/Charities or Organization/s Memorial Contributions RequestedYesNoAddress City State Zip Other InformationPictureMax. file size: 1 GB.A picture can be used in the newspaper with the obituary or it may be used for the hairdresser to referenceNext of Kin Name(Required) Next of Kin contact number(Required)Next of Kin email(Required) Next of Kin Address(Required) City(Required) State(Required) Zip(Required) Sender's Name(Required) Sender's contact number(Required)Sender's e-mail(Required) EmailThis field is for validation purposes and should be left unchanged. Δ
