Submit Vitals - Hilgenfeld Mortuary

Full Name
First Last
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to Decedent
Decedent's Information
Name
First Middle Last
Aka, Also Known As-- include full AKA
Date Of Birth mm/dd/ccyy
Date Format: MM slash DD slash YYYY
Sex
Birth State/ Foreign Country
Ever In US Armed Forces?
- Yes
- No
- UNK
Marital Status (At Time Of Death)
Date Of Death mm/dd/ccyy
Date Format: MM slash DD slash YYYY
Hour (24 Hours)
Education (Highest Level/Degree)
Was Decedent Spanish/Hispanic/Latino?
- Yes
- No
Decedent's Race (Up To 3 Races May Be Listed)
Usual Occupation - Type Of Work For Most Of Life
Kind Of Business Or Industry (e.g..grocery store, road construction, employment agency, etc.)
Years Of Occupation
Decedent's Residence (Street and number or location)
City
Country/Province
Zip Code
Years In County
State/Foreign Country
Name Of Surviving Spouse
First Name Middle Name Last Name
Name Of Father
First Name Middle Name Last Name
Birth State
Name Of Mother
First Name Middle Name Last Name (Maiden Name)
Birth State
Place Of Final Disposition

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