Funeral Arrangement Form

All answers are important. If you are unsure or do not know the correct details, please indicate appropriately.
Details of person completing the Arrangement Form
Authorised Person's Name (name of person completing this form)*
Relationship To Deceased*
Your Email Address*
Your Mobile Phone Number
Your Home or Work Phone Number
Address
Street Address Address Line 2 City State Post Code Country

Authorisation
Authorised Person*
I, the Authorised Person noted above, hereby certify that I am legally entitled to give the above instructions and indemnify Queensland Discount Funerals from any legal proceedings resulting from my not being the person legally entitled to give the above instructions.
*
- I agree
Payment
I agree to pay Queensland Discount Funerals the agreed full payment at least 24 hours before the funeral occurs only by credit card or electronic transfer.
*
- I agree
THE PAYMENT CAN ONLY BE MADE BY CREDIT CARD BY CALLING 1800 453 312 OR ELECTRONIC TRANSFER TO OUR BANK ACCOUNT - WESTPAC ACCOUNT BSB 032-044 ACCOUNT NUMBER 772711 AND NOT BY MAIL OR IN PERSON. PLEASE BE AWARE THAT WE DO NOT BILL SOLICITORS, TRUST OFFICES OR ANY OTHER THIRD PARTIES.