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Guiding Families for Over 100 Years

Family Owned and Operated
By the Vigliante Family

190 East Main St. Smithtown, NY 11787
631-724-9500
551 Route 25A
Miller Place, NY 11764
631-744-9700

Pre-Arrange Online

 

Pre-Planning gives you Peace of Mind and saves you money...

Most families we serve are comforted by the knowledge that their loved ones will be spared the hardship of making decisions at such a difficult and sensitive time. In addition, pre-planning allows for pre-financing. This will guarantee the price of the funeral and merchandise selected.

1. Relieve emotion burden from loved ones.

2. Express your own wishes.

3. Relieve a financial burden from those you love.

4. Allows you to make decisions at your own pace without emotional stress.

5. A family can share their choices and decide together.

THE CHOICE IS YOURS

  • You can make these decisions before a death occurs.
  • You can wait until a life altering event forces you to make them.

Last Name:

First Name:

Middle Name:

E-mail:

Address:

City:

County:

State:

Zip Code:

Phone:

 

Vital Statistics 
 

Marital Status:

 

 

Social Security#:

 

 

Date of Birth:

 

 

Place Of Birth:

 

 

Spouse's Name:

 

 

Spouse's Maiden Name:

 

 

Place of Marriage:

 

 

Date of Marriage:

 

 

Father's Name:

 

 

Mother's Name:

 

 

Mother's Maiden Name:

 

 

 

Work/Education 
 

Education (0-12):

College 1-5+:

Occupation:

Business:

Company:

 

Military Record 
 

Branch of Service:

 

 

Serial Number:

 

 

Date Enlisted:

 

 

Rank At Discharge:

 

 

Date Discharged:

 

 

Discharge On File At:

 

 

Copy of Discharge Papers:      Yes      No

Name Of  Wars:

 

Funeral Service Info 
 

Place Of Service:

Funeral Home:

Address:

Phone:

Place of Visitation:

Religious Denomination:

Place Of Worship:

Lodge / Union:

Person in Charge of Final Arrangements:

 

Special Instructions 
 

Flower Preference:

 

 

Music

 

 

Casket Bearers (6):

  • 1.       
  • 2.       
  • 3.       
  • 4.       
  • 5.       
  • 6.       

 

 

Jewelry:

 

 

Glasses:

 

 

Clothing:

 

 

Other:

 

 

 

Disposition Request 
 

I Prefer:

Cemetery:

Address:

 

 

Phone:

 

 

Section:

Location:

I have made a last will and testament:      Yes      No

 


Other Instructions 

Please list any other instructions you may have:

 

 

Memorials/Donations
 

Please list any Memorials or Donations to Charity that you would like:

 

 

Options
 

Please select one of the options below:

 Send information about pre-arrangement

 Contact me to set an appointment

 Please keep my information on file

 

 

 

 

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Our Locations:

190 East Main St., Smithtown, NY 11787
Smithtown Funeral Homes

551 Route 25A, Miller Place, NY 11764
Miller Place funeral homes

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Proudly Serving the Communities of Smithtown, St. James, Hauppauge, Nesconset, Lake Grove, Kings Park, Commack, Centereach, Village of the Branch, Head of the Harbor, Nissequogue, Stony Brook, Miller Place, Mount Sinai, Wading River, Rocky Point, Sound Beach, Port Jefferson, and Ridge

631-724-9500 190 East Main St. | Smithtown, NY 11787 | Fax: 631-724-7824 | Email: info@branchfh.com
551 Route 25A | Miller Place, NY 11764 | Fax: 631-744-8700 | Email: info@branchfh.com