INFORMATION REQUEST FORM

AZ STATE REGULATED INSURANCE FUNDED FIXED PRICE PRE-ARRANGED CREMATION 
LOCK IN THE PRICE & STOP INFLATION. PAYMENT PLAN AVAILABLE UP TO AGE 90

DIRECT CREMATION $883.15
UP TO 240 POUNDS

DIRECT CREMATION $1,083.15
WEIGHT 241-400 POUNDS

 
PALM VALLEY FUNERAL HOME 

PRICE INCLUDES PROFESSIONAL SERVICES, REMOVAL FROM PLACE OF DEATH IN MARICOPA COUNTY, REFRIGERATION, TRANSPORTATION TO CREMATORY, CREMATION FEE, ALTERNATIVE CONTAINER FOR CREMATION, MINIMUM URN FROM CREMATORY, SALES TAX & PERMIT​

I GIVE PERMISSION FOR ONE LICENSED AGENT IN THE STATE OF ARIZONA TO CONTACT ME REGARDING CREMATION PLANNING AHEAD.  I UNDERSTAND THERE IS NO OBLIGATION TO PURCHASE.  THIS PLAN IS ONLY AVAILABLE IN MARICOPA COUNTY.  HOWARD LAWSON INSURANCE SERVICES, LLC IS THE AZ LICENSED INSURANCE PRODUCER.