Arrangements

Joseph A. Ward Funeral Home is here to help. Whether you’re planning in advance (see also “Pre-Planning“) or making new arrangements for a family member, loved one or friend, we are available to offer guidance and important information. Please contact us day or evening.

In the event of an emergency please call us: 610-485-2425.

Vital Statistics Form

Below you’ll fine an online Vital Statistics Form, which is designed to help with details needed during the arrangement process. All items are required, and noted with an asterisk*.

In order to complete the death certificate, the following fields are necessary and included in this form:  (Deceased) Date of birth, Social security number, Current Mailing address, Marital status and spouse (if applicable), Place of birth (city, state), Highest level of education, Occupation (for longest period of time), Parent names, Military service?, Next of kin full name & address. There is also a field for any additional information you wish to provide.

This 4-part online form includes a “save and resume” feature in the event you’re temporarily missing details.

Please enable JavaScript in your browser to complete this form.

- Step 1 of 4

This form completed by (YOUR First and Last Name): *

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Your Email: *

YOUR Phone (no hyphens): *

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Following details apply to the deceased ONLY.

Full Name of Deceased: *

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Date of Birth (mm/dd/yyyy): *

Social Security Number (no hyphens):

(Deceased) Current Mailing Address: *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

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Race *Select OneHispanic or LatinoNon-Hispanic or LatinoNo Response

Marital Status *Select OneMarriedDivorcedWidowedNever Married

Surviving Spouse (with maiden name if applicable) *

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(Deceased) Place of birth (City, State): *

Highest Level of School Completed: *

Occupation (for longest period of time): *

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Mother's Name (with maiden name): *

Father's Name: *

Was deceased ever in military? *Select OneYesNoUnknown

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Full name and address of legal next of kin (will appear on death certificate)

Full Name (Next of kin - First and Last Name TO APPEAR ON DEATH CERTIFICATE): *

Address (Next of kin): *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

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Additional Information:

Please help by validating this form below.

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