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Vital Statistics Form

Vital Statistics Registration Details

You are invited to complete this form if you would like KORU to keep your details on file for future use.

This information is standard and requested by every funeral home whether planning ahead or following a death.

We thank you for entrusting us with this information.

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Your Name *

Your Email *

Your Phone

Please describe your connection to the person we are planning for (self, parent, friend, etc.)

Who Are We Planning For?

Legal Name *

First

Middle

Last

Full name as it appears on the Passport, Birth Certificate, or Canadian Citizenship Card.

Name at Birth *

Email

Phone

Current Legal Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Is there a Will in place?

Legal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country