This information is for guidance at such time of my death. Preferences on certain subjects have been expressed, and unless changed by unforeseen circumstances, are desired.

WHEN THE NEED ARISES, I WISH

that LAMB & HAYWARD FUNERAL DIRECTORS
be contacted to conduct all necessary arrangements for my funeral. A copy of my own personal wishes expressed below is held at their office:

Funeral Service to be held at:

If Other, please specify:

Cremation at:

If Other, please specify:

Burial at:

If Other, please specify:

Burial Plot No. / Ashes to be interred at:

Notices in Newspapers:

If Other, please specify:

Before/After Service:

Age in Newspaper:

Mention of flowers:

Donations to:

RSA/Lodge/Clubs/Other Affiliations:

Service Preferences

Catering:

If Other, please specify:

Amount:

Date:

Further details I would like observed:

DETAILS FOR THE REGISTRAR OF BIRTHS, DEATHS & MARRIAGES

PERSONAL:

Full name of your FATHER

Full name of your MOTHER

Occupation of your father

Occupation of your mother

Where were you born

Years in N.Z.

Where married:

1st time

2nd time

3rd time

Age at marriage:

1st time

2nd time

3rd time

To whom married:

1st time

2nd time

3rd time

Age of daughter's living:

Age of son's living:

Wife's or husbands age if living:

If ex-service person, state service:

Service No.:

Rank:

Regiment:

If served overseas, which war

(1914-18, 1939-45 ETC):

If served in N.Z. state when:

Name of NEXT OF KIN:

Address of NEXT OF KIN:

If you are a holder of title or J.P., please specify:

OTHER PERSONAL DETAILS:

My Will is held by:

Solicitor:

Society/Club Memberships: