Pre-Purchase Forms: Page 1 of 3 Back Page 2 or 3
PREPAID FUNERAL CONTRACT
page 1
THIS AGREEMENT entered into this ____ day of _____________________, 20____.
SELLER: Caring Caskets, 28 South College, Suite 17, Fayetteville, Arkansas
72701, (479) 443-6414
BUYER: __________________________ BENEFICIARY: ______________________
(Name) (Name)
______________________________ _________________________
(Social Security Number) (Social Security Number)
______________________________ _________________________
(Address) (Address)
______________________________ _________________________
_______________________________ _________________________
_______________________________ __________________________
(Phone) (Phone)
Buyer shall notify Seller of any changes of address. An additional delivery cost shall be required if delivery is to be made more than 50 miles from Fayetteville, Arkansas as a result of the change of address.
MERCHANDISE AND SERVICES:
Pursuant to A.C.A §23-40-109, Seller hereby agrees to sell and Buyer(s) hereby agree to buy the following described merchandise and services: Regardless of the cost of the merchandise and services at the date of the beneficiary death.
1st Choice: Burial casket _______________________ Metal Gauge________________
Exterior Color ______________________ Interior Color _______________
Brushed Top and Sides? Yes, No Has Gasket? Yes, No
2nd Choice: Burial casket _______________________ Metal Gauge________________
Exterior Color ______________________ Interior Color _______________
Brushed Top and Sides? Yes, No Has Gasket? Yes, No
DELIVERY: ______ at time of execution of this Agreement.
______ at time of death of Beneficiary. Buyer or Buyer's family/relative is to
give Seller Reasonable notice of this date.
