After selecting one of the following, purchaser(s) is to initial the selected payment option.
1. A discount of $__________ shall be offered if total balance due is paid by cash or check no later than, ___________.
2. A payment of $____________ is required at the time of the funeral arrangement conference by cash, check or credit card.
3. Life Insurance: Once it has been determined that the policy is active, non-contestable, and assignable, the beneficiary is required to sign an assignment form for the amount of the funeral services requested. A service fee of 4% will be incurred of the total funeral amount which covers the fees of a third-party processor.
If life insurance proceeds are not sufficient to pay the expenses, another option must be selected.
4. More Than One Purchaser: In the case where two or more purchasers will share in payment of the total funeral bill, we require that the purchasers designate one purchaser to be responsible to the funeral home for the total balance due.
5. Crowd Funding: The funeral home’s website has a donation feature and those proceeds are made payable directly to our funeral home. A 5% processing fee will be deducted from the total donations.
REGARDLESS of which option is selected, total balance due is to be paid in full by cash, check, or credit card within 15 days from the day of the service or disposition.
In all cases where the total payment has not been received in 15 days, a Late Payment Charge of 1.5% per month (18% per year) shall be added beginning on the 16th day. There will be no exceptions.
Signature of Purchaser_ _____________________________ Date of Birth: ____________
Print Name: __________________________________Social Security No:______________
Signature of Purchaser____________________________ Date of Birth: ______________
Print Name: _________________________________ Social Security No:______________
Signature of Purchaser___________________________ Date of Birth: _______________
Print Name: ________________________________ Social Security No:_______________
Thompson-Marodi Funeral Home, Inc., 809 Main St., Bentleyville, PA 15314