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PRE-ARRANGEMENTS
Client Profile
Client Profile
To help your family make arrangements
please complete any of the following fields:
Name:*
Address:
My next of kin is:
Date of birth:
I would like to be embalmed:
I would like to be viewed:
at:
I would like to be:
I would like to buried at:
Or I would like my ashes to be:
Plot (if applicable):
The style of casket I would like is:
My place of birth:
My nationality:
I would like notices placed in the following papers:
Others:
Waitomo News
NZ Herald
Waikato Times
Children
Name and Date of Birth of each daughter (please include any deceased children and age when died)
Name and Date of Birth of each son (please include any deceased children and age when died)
Parents
Mother's full name:
Mother's full name at birth:
First or Given Names
Surname or Family Name
Father's full name:
Father's full name at birth:
First or Given Names
Surname or Family Name
I would like:
Flowers on my casket:
Committal flowers/petals:
Service sheets/bookmarks:
Memorial book at the service:
Reflection DVD/Slideshow during my service:
Photo board:
Piper:
I would like the following music, hymns, readings and/or poems at my funeral:
I would like the following pallbearers:
I would like donations to be made to:
Other instructions: e.g. refreshments after the service or information for eulogy
Marital Status:
Most recent Relationship
To Whom Married (including Maiden Name):
Age of living partner:
Age Dec'd at marriage:
Where Married:
Previous Relationship
To Whom Married (including Maiden Name):
Age of living partner:
Age Dec'd at marriage:
Where Married:
Previous Relationship
To Whom Married (including Maiden Name):
Age of living partner:
Age Dec'd at marriage:
Where Married:
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Date
.
Your content has been submitted. We will get back to you as soon as possible.
Please fill in the input field(s) highlighted in red before submitting.
Headstone Details
Name of contact:*
Contact telephone number:
Email of contact:*
Contact mailing address:
Name on monument:*
Date of birth:*
Date of death:*
Photo:
Vases:
Dates to be numerical or words:
Shape of plate:
(choose from the pamphlet, display room or photographs
Shape of base:
(regular rectangle, bevelled centre, desk or other)
Family names to be included:
Interests, hobbies or groups enjoyed for a picture:
(flowers, pets, sports etc)
Cultural or religious symbols:
Colour of the plate:
Colour of base:
To be installed at:
(Name of cemetery or urupa if we are to install.
Otherwise put ‘supply only’)
By:
Quotes:
(unveiling date)
To receive a copy of this filled form please provide your email address:
by:
by:
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Please fill in the input field(s) highlighted in red before submitting.
Pre-Paid Funeral Plans
Surname:*
First name(s):*
Address:*
Phone:
IRD number:
Next of kin:
Mob:
DOB:*
Next of kin phone:
Next of kin address:
I authorise on the proof of my death that the proceeds of my pre-paid funeral account be paid to V J Williams & Sons
Your signature:
Date:
How do you wish to pay? (tick one):
To receive a copy of this filled form please provide your email address:
Date value
Date value
Your content has been submitted. We will get back to you as soon as possible.
Please fill in the input field(s) highlighted in red before submitting.
Terms and conditions
1. Purpose
The investment is intended for paying for funeral and / or monument expenses of the account holder
2. Definitions
-
Account – The V J Williams & Sons Client Fund Account opened in the name of the account holder
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Account holder – The person named on the account application form
-
Entitlement – The funds deposited, plus net interest (after resident withholding tax deducted)
3. Withdrawals
No withdrawals are permitted during the lifetime of the account holder, except for:
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During the 30-day cooling off period following the opening of the account
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Financial hardship of the account holder (proof supplied to V J Williams & Sons by Work & Income NZ, chartered accountant or bank manager)
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The account holder residing permanently overseas
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At the discretion of V J Williams & Sons
4. Disbursement of funds
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The balance of the fund to be paid in accordance with the withdrawal guidelines above to the account holder.
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Funds will be drawn by V J Williams & Sons to contribute towards the cost of the funeral and / or monument upon receipt of the death certificate of the account holder and / or an invoice rendered for services
5. Interest
Interest is calculated on a daily basis and credited quarterly to the account holder’s account
6. Interest rate
The interest rate is the Bank of New Zealand’s client fund on-call interest rate and subject to change as per the terms of the account.
7. Fees
There are no fees charged to the pre-paid funeral account
8. Account statements
A Pre-paid funeral account statement will be sent to the account
holder (at the last known address) as at 31st March annually
9. Payments
Contributions to the pre-paid funeral account can be made by
i) Single lump sum
ii) Casual lump sum
iii) Regular automatic payment
10. Certificate
On receipt and clearance of pre-paid funeral payment V J Williams & Sons will send the account holder a certificate acknowledging
the opening of the account holder’s account
11. Auditing
The Client Fund account of V J Williams & Sons is audited by the firm’s accountant annually
12. Asset testing exemption
The Ministry of Social Development allows a maximum of $10,000 to be held in a funeral plan and not subject to asset testing.
13. Balance of account
Any funds remaining after funeral and / or monument expenses have been settled will be paid to the estate of the account holder
PrePaidFuneralPlans
Headstone Details
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