Contract for Prepaid Funeral Arrangements

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This Contract for Prepaid Funeral Arrangements will specify exactly what the deceased wants for his or her funeral. It also specifies how the contract is paid and seller's rights in the event of default or cancellation of of the contract.

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This Contract for Prepaid Funeral Arrangements will effectively set forth the terms of a funeral service and funeral merchandise that has been prepaid for by the deceased (or deceased’s loved ones). This contract clearly sets forth where the funeral services will be held, if a clergy member should deliver the services and if the deceased desires to be interred or cremated. It also sets out any special requests for a memorial or prayer services, type of casket to be selected and specification of any materials to be used in the grave if the body is interred.

The contract sets out the payment terms if paid in monthly installments and who will be responsible for any outstanding amount if the account is not paid in full at the time of purchaser's death. It also spells out seller's rights if the purchaser defaults or cancels the contract, or how the contract will be paid if funded by a trust.

This Contract for Prepaid Funeral Arrangements includes:
  • Parties: Sets forth specific information about the purchaser and the funeral home/mortuary which will provide funeral services;
  • Services/Merchandise: Sets out where the services will be held, who will officiate, if the body will be interred or cremated and other specific merchandise to be provided. A detailed list of services and their cost is included;
  • Payment Terms: Payment terms (i.e. if paid in full or via installments), finance charges and how the balance will be paid if payments are due after the purchaser's death;
  • Default and/or Cancellation: Provisions regarding cancellation or default by either party;
  • Signatures: The seller and purchaser must sign the contract.

Protect yourself and your rights by using our attorney-prepared forms.

This attorney-prepared packet contains:
  1. General Information
  2. Instructions and Checklist
  3. Contract for Prepaid Funeral Arrangements
State Law Compliance: This form complies with the laws of all states
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Contract for Prepaid
Funeral Arrangements
 

 

Name of Seller/Provider: _________________
Permit Number: _________________
Address: _________________
Telephone Number: _________________
Name of Purchaser: _________________
Address: _________________
Telephone Number: _________________
 
This is an Agreement between _________________ [name of funeral services seller/provider] (referred to in this Contract as the Seller/Provider”), _________________ [identity if necessary, e.g., a __________ [state] corporation], and _________________ [name of recipient of funeral services] (referred to in this Contract as the Purchaser”) for the sale and purchase of prepaid funeral services and funeral merchandise from Seller/Provider to Purchaser. Purchaser and Seller/Provider are collectively referred to in this Contract as the Parties.
 RECITAL
The purpose of this Contract is to state the terms and conditions under which Seller/Provider will provide prepaid funeral services and funeral merchandise for Purchaser and the terms and conditions under which Purchaser pays Seller/Provider for the funeral services and merchandise.
In consideration of the mutual promises contained in this Contract, Seller/Provider and Purchaser agree as follows:
1.  SERVICES AND FUNERAL MERCHANDISE
General Provisions
 (a) As soon as convenient after the death of Purchaser, Seller/Provider shall conduct, or pay the necessary expenses to have conducted, the funeral for the body of Purchaser in the following manner:
Services to be held at: _________________
Clergy member to be: _________________
Lodge or society to officiate: _________________
Interment to be at: _________________
Cremation: _________________
If cremation, disposition of ashes: _________________
Other (list and describe fully and give retail list price): _________________
Specific Services and Merchandise to Be Provided
 
(a) At some undetermined future date dependent on the death of Purchaser, Seller shall furnish the following merchandise and services, or their equivalent in quality, for the exact listed amounts, for the funeral of Purchaser:
CHARGES ARE ONLY FOR THOSE ITEMS THAT YOU SELECTED, OR THAT ARE REQUIRED. IF WE ARE REQUIRED BY LAW OR BY A CEMETERY OR CREMATORY TO USE ANY ITEMS, WE WILL EXPLAIN THE REASONS IN WRITING BELOW;
 
                        TYPE         DESCRIPTION           AMOUNT
 
Professional Services:     ___________________________     $ ____________
Facilities and Staff:         ____________________________   $ ____________
Hearse and Motor Equipment: _______________________      $ ____________
Casket Selection:  _________________________________      $ ____________
Specification of Material Used in Casket_______________     $ ____________
Embalming:              _______________________________      $ ____________
Transportation of Remains:  _________________________      $ ____________
Use of Chapel:  ___________________________________      $ ____________
Use of Other Funeral Home Facilities            $ ____________
(describe fully): __________________________________
Outside Receptacle:  ______________________________      $ ____________
Grave Vault:   ____________________________________     $ ____________
Specification of Material used in Grave:  _______________            $ ____________
Vault:  ____________________________________      $ ____________
            Clothing:  _________________________________      $ ____________
Cemetery or Crematory Charges: _____________________   $ ____________
Certified Copies of Death Certificate:  _________________   $ ____________
Newspaper Notices: _______________________________      $ ____________
Contribution to Church or Clergyman:  ________________      $ ____________
Flowers:  ________________________________________   $ ____________
Miscellaneous Items (list and describe fully):         $ ____________
________________________________________________
 
SUBTOTAL                                $ ____________
                          Sales Tax:          ___ Percent              $ ____________
                          GRAND TOTAL                              $ ____________
NO CEMETERY CHARGES ARE INCLUDED IN THE GRAND TOTAL AMOUNT UNLESS LISTED ABOVE.
IF YOU SELECTED A FUNERAL THAT MAY REQUIRE EMBALMING, SUCH AS A FUNERAL WITH VIEWING, YOU MAY HAVE TO PAY FOR EMBALMING. YOU DO NOT HAVE TO PAY FOR EMBALMING YOU DID NOT APPROVE IF YOU SELECTED ARRANGEMENTS SUCH AS A DIRECT CREMATION OR IMMEDIATE BURIAL. IF WE CHARGED FOR EMBALMING, WE WILL EXPLAIN WHY BELOW:
REASON FOR EMBALMING: _________________
NOTE: If any legal, cemetery, or crematory requirement has required the purchase of the items listed above, we will explain the requirement below:_________________
 
2.  TERMS OF PAYMENT
General Provisions
_________________ [Set out terms of payment, e.g.,
(a) Purchaser shall pay to Seller the sum of $ _________________ per month, due and payable on the _________________ day of each month, for a period of _________________ months, beginning _________________ (date). All payments shall be made at _________________ (address).
[OR]
(a) Purchaser shall pay to Seller $ _________________ in _________________equal installments, with the first due on _________________ (date), and an equal installment due and payable on the _________________ day of each succeeding month until paid in full. All payments shall be made at _________________ (address)].
Outstanding Payments at Time of Death
(b) If the Contract price is not paid in full on the death of the person designated by Purchaser to receive the benefits, _________________[describe impact, e.g., the difference between the total amount owed under the Contract and the payments made shall become immediately due and payable to Seller/Provider. If, on Seller/Providers written demand, those responsible for the funeral do not pay the difference, the Contract terminates, and Seller/Provider must refund the amount on deposit in trust, less interest and authorized retainage to which Seller/Provider is entitled].
Finance Charge
 (c) This Contract is subject to a finance charge provision. _________________ [Fully describe charge and/or refer to separate finance agreement with consumer credit disclosure].
3.  PROVIDERS DUTY
Seller/Provider (who is the provider of benefits specified in this Contract) agrees to furnish the described prepaid funeral benefits or their equivalent in quality, for a price not to exceed the Contract price for funeral merchandise and professional services, excluding any finance charges and charges for credit or decreasing term life insurance, at an undetermined future date dependent on the death of the person designated by the purchaser to receive the prepaid funeral benefits.
4.  RIGHTS ON DEFAULT OR CANCELLATION
Purchasers Default
 _________________ [Describe consequence of purchasers default, e.g., If Purchaser defaults on any payment due on the Contract, and is in default for more than 30 days, Seller/Provider shall be relieved of the obligation to deliver the Funeral Service at Contract Maturity, and purchaser shall be entitled to the amount on deposit in trust under this Contract, less interest and retained funds to which Seller/Provider is entitled.
5.  CANCELLATION BY EITHER PARTY
 _________________ [Explain effect of cancellation on purchaser, e.g., Purchaser may cancel the Contract at any time by giving the Seller/Provider notice. Within a reasonable period of time after the cancellation, not to exceed 30 days, Seller/Provider must refund to Purchaser the amount on deposit in trust under the Contract, less any interest and retainage to which Seller/Provider is entitled. However, if Purchaser cancels the Agreement during the first year at a time when payments are current, Purchaser is entitled to the amounts specified in Paragraph 12 of this Contract].
_________________ [Explain effect of breach or cancellation by seller/provider, e.g., If Seller/Provider breaches this Contract, Seller/Provider shall return to Purchaser, at the time notice of cancellation is given or within a reasonable period of time thereafter (not to exceed 30 days), the full amount of all funds paid under the Contract together with their enhanced value.]
6.  NOTICE OF IRREVOCABLE WAIVER OF CONDITION
The purchaser may irrevocably waive and renounce the right to cancel the Contract by executing a written waiver.
7.  NOTICE THAT NO PARTIAL CANCELLATIONS OF CONTRACT ARE PERMITTED
It is acknowledged by the parties that neither the Purchaser nor the Seller/Provider may make partial cancellations of the Contract.
8. USE OF A DIFFERENT PROVIDER AS CANCELLATION
Unless the Seller/Provider agrees otherwise, the Purchasers use of a provider that is not named in the original Contract is a cancellation of the original Contract by Purchaser.
9.  FUNDING AND DEPOSITS
Funding Plan
This is a trust-funded Contract. The trust is funded with _________________ [100 percent (Plan I) or 90 percent (Plan II)] of the purchasers payments under the Contract.
 Deposit of Purchasers Payments
 Within 30 days of collection, Seller/Provider will deposit the funds collected from the purchaser, less any retainage, finance charges, and charges for credit or decreasing term life insurance, in a depository within ________ [state] that has been approved by the Department of Banking.
[Add if seller plans to retain funds, Seller/Providers Retention of Monies Received]
The Seller/Provider plans to retain one-half of the funds collected (excluding any finance charges and charges for credit or decreasing term life insurance) not exceeding 10% of the total amount of the Contract. If Purchaser cancels the Contract during the first year at a time when Contract payments are current, the Seller/Provider will receive 90% of the amounts paid in by the purchaser (excluding any finance charges and charges for credit or decreasing term life insurance) or the amounts deposited in trust under the Contract, whichever is greater.
10.  GENERAL AND MISCELLANEOUS PROVISIONS
Change of Address
Each party to this Contract will notify the other party to the Contract of any change in that partys address. [The notification must be in writing, and given within _________________ days after the change occurs.]
Acceptance/Modification of Contract; Entire Agreement
The Contract and any separate agreements to irrevocably waive the right to cancel the Contract, to irrevocably assign life insurance or annuity benefits, and/or to pay finance charges constitute the entire agreement. The Contract is binding when accepted by a duly authorized representative of the Seller/Provider. Except as specifically provided otherwise in this Contract, the Contract can be modified only by written supplement signed by the Seller/Provider and Purchaser. This Contract is binding on the successors, assigns, beneficiaries, heirs, and legal representatives of all the parties.
________ [state] Law to Apply
This Contract shall be construed under and in accordance with the laws of The State of ___________, and all obligations of the parties created in this Contract are performable in _________________ County, _______________ [state].
Legal Construction
In case any one or more of the provisions contained in this Contract shall for any reason be held to be invalid, illegal, or unenforceable in any respect, that invalidity, illegality, or unenforceability shall not affect any other provision in this Contract and this Contract shall be construed as if the invalid, illegal, or unenforceable provision had never been contained in it.
Distribution of Copies
The _________________ [Seller or Seller/Provider] will receive the original of the executed Contract with a copy to each of the following _________________ [designate, as appropriate, purchaser, provider if not the same as seller, and insurance copy in case of insurance funded Contract].
Purchasers Receipt of Contract
Purchaser acknowledges receiving a copy of the Contract at the conclusion of the discussion of arrangements.
Inquiries and Complaints
Purchaser may address inquiries and complaints to Seller/Provider. In the event of unresolved issues, Purchaser may contact the ______________ [state] Department of Banking, which regulates prepaid funeral benefits contracts, or the ____________ [state] Funeral Service Commission, as follows:
11.  ACKNOWLEDGMENTS AND DISCLAIMERS
[Add as appropriate]
Acknowledgment of Receipt of Copy of Price List and Memorandum of Fees and Charges
Purchaser acknowledges that Seller/Provider provided to Purchaser a personal copy of an itemized list of funeral services and funeral goods, showing the effective date for prices as _________________ [date], and including a casket price list and an outer burial container price list, offered by Seller at the beginning of the discussion of caskets, outer burial containers, funeral goods, and funeral services. Seller has also provided to Purchaser a Memorandum itemizing the description and costs of services and goods to be provided for the decedent.
Compliance With Law
In performing the services required under this Contract, Seller/Provider shall comply with all applicable federal, state, county, and city statutes, ordinances, and regulations. If compliance is impossible for reasons beyond its control, Seller/Provider shall immediately notify Purchaser, or if Purchaser is deceased, Purchasers heirs, of that fact and the reasons for noncompliance.
Disclaimer of Warranties
SELLER/PROVIDER DISCLAIMS ANY WARRANTY OF MERCHANTABILITY AND ANY WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE FUNERAL GOODS SOLD BY THIS AGREEMENT. THE ONLY EXPRESS WARRANTIES OR IMPLIED WARRANTIES THAT EXIST FOR THE FUNERAL GOODS SOLD UNDER THIS AGREEMENT ARE THE EXPRESS WRITTEN WARRANTIES, IF ANY, FROM THE MANUFACTURERS OF THE FUNERAL GOODS.
 
[Include here, if not included earlier in contract any other disclosures required by law, such as additional FTC notices, home solicitation cancellation rights, tax notice, etc.]
 
EXECUTED AT _________________ [city], _________ [state], on _________________ [date]
 
SELLER/PROVIDER
_________________ [typed name]
_________________ [signature]
_________________ [typed name and title]
_________________ [address]
_________________ [telephone number]
_________________ [telecopier number, if any]
 
PURCHASER
_________________ [typed name]
_________________ [signature]
_________________ [address]
_________________ [telephone number]
_________________ [telecopier number, if any] 
 
 
 
Number of Pages10
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#43647
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Contract for Prepaid
Funeral Arrangements
 

 

Name of Seller/Provider: _________________
Permit Number: _________________
Address: _________________
Telephone Number: _________________
Name of Purchaser: _________________
Address: _________________
Telephone Number: _________________
 
This is an Agreement between _________________ [name of funeral services seller/provider] (referred to in this Contract as the Seller/Provider”), _________________ [identity if necessary, e.g., a __________ [state] corporation], and _________________ [name of recipient of funeral services] (referred to in this Contract as the Purchaser”) for the sale and purchase of prepaid funeral services and funeral merchandise from Seller/Provider to Purchaser. Purchaser and Seller/Provider are collectively referred to in this Contract as the Parties.
 RECITAL
The purpose of this Contract is to state the terms and conditions under which Seller/Provider will provide prepaid funeral services and funeral merchandise for Purchaser and the terms and conditions under which Purchaser pays Seller/Provider for the funeral services and merchandise.
In consideration of the mutual promises contained in this Contract, Seller/Provider and Purchaser agree as follows:
1.  SERVICES AND FUNERAL MERCHANDISE
General Provisions
 (a) As soon as convenient after the death of Purchaser, Seller/Provider shall conduct, or pay the necessary expenses to have conducted, the funeral for the body of Purchaser in the following manner:
Services to be held at: _________________
Clergy member to be: _________________
Lodge or society to officiate: _________________
Interment to be at: _________________
Cremation: _________________
If cremation, disposition of ashes: _________________
Other (list and describe fully and give retail list price): _________________
Specific Services and Merchandise to Be Provided
 
(a) At some undetermined future date dependent on the death of Purchaser, Seller shall furnish the following merchandise and services, or their equivalent in quality, for the exact listed amounts, for the funeral of Purchaser:
CHARGES ARE ONLY FOR THOSE ITEMS THAT YOU SELECTED, OR THAT ARE REQUIRED. IF WE ARE REQUIRED BY LAW OR BY A CEMETERY OR CREMATORY TO USE ANY ITEMS, WE WILL EXPLAIN THE REASONS IN WRITING BELOW;
 
                        TYPE         DESCRIPTION           AMOUNT
 
Professional Services:     ___________________________     $ ____________
Facilities and Staff:         ____________________________   $ ____________
Hearse and Motor Equipment: _______________________      $ ____________
Casket Selection:  _________________________________      $ ____________
Specification of Material Used in Casket_______________     $ ____________
Embalming:              _______________________________      $ ____________
Transportation of Remains:  _________________________      $ ____________
Use of Chapel:  ___________________________________      $ ____________
Use of Other Funeral Home Facilities            $ ____________
(describe fully): __________________________________
Outside Receptacle:  ______________________________      $ ____________
Grave Vault:   ____________________________________     $ ____________
Specification of Material used in Grave:  _______________            $ ____________
Vault:  ____________________________________      $ ____________
            Clothing:  _________________________________      $ ____________
Cemetery or Crematory Charges: _____________________   $ ____________
Certified Copies of Death Certificate:  _________________   $ ____________
Newspaper Notices: _______________________________      $ ____________
Contribution to Church or Clergyman:  ________________      $ ____________
Flowers:  ________________________________________   $ ____________
Miscellaneous Items (list and describe fully):         $ ____________
________________________________________________
 
SUBTOTAL                                $ ____________
                          Sales Tax:          ___ Percent              $ ____________
                          GRAND TOTAL                              $ ____________
NO CEMETERY CHARGES ARE INCLUDED IN THE GRAND TOTAL AMOUNT UNLESS LISTED ABOVE.
IF YOU SELECTED A FUNERAL THAT MAY REQUIRE EMBALMING, SUCH AS A FUNERAL WITH VIEWING, YOU MAY HAVE TO PAY FOR EMBALMING. YOU DO NOT HAVE TO PAY FOR EMBALMING YOU DID NOT APPROVE IF YOU SELECTED ARRANGEMENTS SUCH AS A DIRECT CREMATION OR IMMEDIATE BURIAL. IF WE CHARGED FOR EMBALMING, WE WILL EXPLAIN WHY BELOW:
REASON FOR EMBALMING: _________________
NOTE: If any legal, cemetery, or crematory requirement has required the purchase of the items listed above, we will explain the requirement below:_________________
 
2.  TERMS OF PAYMENT
General Provisions
_________________ [Set out terms of payment, e.g.,
(a) Purchaser shall pay to Seller the sum of $ _________________ per month, due and payable on the _________________ day of each month, for a period of _________________ months, beginning _________________ (date). All payments shall be made at _________________ (address).
[OR]
(a) Purchaser shall pay to Seller $ _________________ in _________________equal installments, with the first due on _________________ (date), and an equal installment due and payable on the _________________ day of each succeeding month until paid in full. All payments shall be made at _________________ (address)].
Outstanding Payments at Time of Death
(b) If the Contract price is not paid in full on the death of the person designated by Purchaser to receive the benefits, _________________[describe impact, e.g., the difference between the total amount owed under the Contract and the payments made shall become immediately due and payable to Seller/Provider. If, on Seller/Providers written demand, those responsible for the funeral do not pay the difference, the Contract terminates, and Seller/Provider must refund the amount on deposit in trust, less interest and authorized retainage to which Seller/Provider is entitled].
Finance Charge
 (c) This Contract is subject to a finance charge provision. _________________ [Fully describe charge and/or refer to separate finance agreement with consumer credit disclosure].
3.  PROVIDERS DUTY
Seller/Provider (who is the provider of benefits specified in this Contract) agrees to furnish the described prepaid funeral benefits or their equivalent in quality, for a price not to exceed the Contract price for funeral merchandise and professional services, excluding any finance charges and charges for credit or decreasing term life insurance, at an undetermined future date dependent on the death of the person designated by the purchaser to receive the prepaid funeral benefits.
4.  RIGHTS ON DEFAULT OR CANCELLATION
Purchasers Default
 _________________ [Describe consequence of purchasers default, e.g., If Purchaser defaults on any payment due on the Contract, and is in default for more than 30 days, Seller/Provider shall be relieved of the obligation to deliver the Funeral Service at Contract Maturity, and purchaser shall be entitled to the amount on deposit in trust under this Contract, less interest and retained funds to which Seller/Provider is entitled.
5.  CANCELLATION BY EITHER PARTY
 _________________ [Explain effect of cancellation on purchaser, e.g., Purchaser may cancel the Contract at any time by giving the Seller/Provider notice. Within a reasonable period of time after the cancellation, not to exceed 30 days, Seller/Provider must refund to Purchaser the amount on deposit in trust under the Contract, less any interest and retainage to which Seller/Provider is entitled. However, if Purchaser cancels the Agreement during the first year at a time when payments are current, Purchaser is entitled to the amounts specified in Paragraph 12 of this Contract].
_________________ [Explain effect of breach or cancellation by seller/provider, e.g., If Seller/Provider breaches this Contract, Seller/Provider shall return to Purchaser, at the time notice of cancellation is given or within a reasonable period of time thereafter (not to exceed 30 days), the full amount of all funds paid under the Contract together with their enhanced value.]
6.  NOTICE OF IRREVOCABLE WAIVER OF CONDITION
The purchaser may irrevocably waive and renounce the right to cancel the Contract by executing a written waiver.
7.  NOTICE THAT NO PARTIAL CANCELLATIONS OF CONTRACT ARE PERMITTED
It is acknowledged by the parties that neither the Purchaser nor the Seller/Provider may make partial cancellations of the Contract.
8. USE OF A DIFFERENT PROVIDER AS CANCELLATION
Unless the Seller/Provider agrees otherwise, the Purchasers use of a provider that is not named in the original Contract is a cancellation of the original Contract by Purchaser.
9.  FUNDING AND DEPOSITS
Funding Plan
This is a trust-funded Contract. The trust is funded with _________________ [100 percent (Plan I) or 90 percent (Plan II)] of the purchasers payments under the Contract.
 Deposit of Purchasers Payments
 Within 30 days of collection, Seller/Provider will deposit the funds collected from the purchaser, less any retainage, finance charges, and charges for credit or decreasing term life insurance, in a depository within ________ [state] that has been approved by the Department of Banking.
[Add if seller plans to retain funds, Seller/Providers Retention of Monies Received]
The Seller/Provider plans to retain one-half of the funds collected (excluding any finance charges and charges for credit or decreasing term life insurance) not exceeding 10% of the total amount of the Contract. If Purchaser cancels the Contract during the first year at a time when Contract payments are current, the Seller/Provider will receive 90% of the amounts paid in by the purchaser (excluding any finance charges and charges for credit or decreasing term life insurance) or the amounts deposited in trust under the Contract, whichever is greater.
10.  GENERAL AND MISCELLANEOUS PROVISIONS
Change of Address
Each party to this Contract will notify the other party to the Contract of any change in that partys address. [The notification must be in writing, and given within _________________ days after the change occurs.]
Acceptance/Modification of Contract; Entire Agreement
The Contract and any separate agreements to irrevocably waive the right to cancel the Contract, to irrevocably assign life insurance or annuity benefits, and/or to pay finance charges constitute the entire agreement. The Contract is binding when accepted by a duly authorized representative of the Seller/Provider. Except as specifically provided otherwise in this Contract, the Contract can be modified only by written supplement signed by the Seller/Provider and Purchaser. This Contract is binding on the successors, assigns, beneficiaries, heirs, and legal representatives of all the parties.
________ [state] Law to Apply
This Contract shall be construed under and in accordance with the laws of The State of ___________, and all obligations of the parties created in this Contract are performable in _________________ County, _______________ [state].
Legal Construction
In case any one or more of the provisions contained in this Contract shall for any reason be held to be invalid, illegal, or unenforceable in any respect, that invalidity, illegality, or unenforceability shall not affect any other provision in this Contract and this Contract shall be construed as if the invalid, illegal, or unenforceable provision had never been contained in it.
Distribution of Copies
The _________________ [Seller or Seller/Provider] will receive the original of the executed Contract with a copy to each of the following _________________ [designate, as appropriate, purchaser, provider if not the same as seller, and insurance copy in case of insurance funded Contract].
Purchasers Receipt of Contract
Purchaser acknowledges receiving a copy of the Contract at the conclusion of the discussion of arrangements.
Inquiries and Complaints
Purchaser may address inquiries and complaints to Seller/Provider. In the event of unresolved issues, Purchaser may contact the ______________ [state] Department of Banking, which regulates prepaid funeral benefits contracts, or the ____________ [state] Funeral Service Commission, as follows:
11.  ACKNOWLEDGMENTS AND DISCLAIMERS
[Add as appropriate]
Acknowledgment of Receipt of Copy of Price List and Memorandum of Fees and Charges
Purchaser acknowledges that Seller/Provider provided to Purchaser a personal copy of an itemized list of funeral services and funeral goods, showing the effective date for prices as _________________ [date], and including a casket price list and an outer burial container price list, offered by Seller at the beginning of the discussion of caskets, outer burial containers, funeral goods, and funeral services. Seller has also provided to Purchaser a Memorandum itemizing the description and costs of services and goods to be provided for the decedent.
Compliance With Law
In performing the services required under this Contract, Seller/Provider shall comply with all applicable federal, state, county, and city statutes, ordinances, and regulations. If compliance is impossible for reasons beyond its control, Seller/Provider shall immediately notify Purchaser, or if Purchaser is deceased, Purchasers heirs, of that fact and the reasons for noncompliance.
Disclaimer of Warranties
SELLER/PROVIDER DISCLAIMS ANY WARRANTY OF MERCHANTABILITY AND ANY WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE FUNERAL GOODS SOLD BY THIS AGREEMENT. THE ONLY EXPRESS WARRANTIES OR IMPLIED WARRANTIES THAT EXIST FOR THE FUNERAL GOODS SOLD UNDER THIS AGREEMENT ARE THE EXPRESS WRITTEN WARRANTIES, IF ANY, FROM THE MANUFACTURERS OF THE FUNERAL GOODS.
 
[Include here, if not included earlier in contract any other disclosures required by law, such as additional FTC notices, home solicitation cancellation rights, tax notice, etc.]
 
EXECUTED AT _________________ [city], _________ [state], on _________________ [date]
 
SELLER/PROVIDER
_________________ [typed name]
_________________ [signature]
_________________ [typed name and title]
_________________ [address]
_________________ [telephone number]
_________________ [telecopier number, if any]
 
PURCHASER
_________________ [typed name]
_________________ [signature]
_________________ [address]
_________________ [telephone number]
_________________ [telecopier number, if any] 
 
 
 

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