LMA FUNERAL PARLOUR

PLEASE NOTE:

If the grave is a re-open, please ensure the form is filled by the original owner/ executor of the grave.

Details must be filled in by Next of Kin (Wife, Husband, Mother, Father, Son, Daughter, Brother, Sister or Legal Representative).

Our Funeral Director will liaise with the Next of Kin only for all burial related matters.

If the Deceased is located at the Coroners, please provide details of who the Coroner liaised with (family member and contact number below).

Please fill in all the required details below so that we can assist in the preparations for the burial of your loved one.

If you have any questions, please do not hesitate to reach out to one of our LMA Funeral Staff.

Deceased Full Name*

First NameLast Name

Has the deceased ever used or been known by any other name (eg: name at birth, maiden name, previous married name?)*

Deceased - Date of Birth*

Date

Deceased - Date of Death*

Date

Deceased - Age at Death*

Sex of the Deceased*

MaleFemale

Deceased Last Known Address (Please include Postcode)*

Deceased Marital Status*

Please confirm if the cause of Death was due to the Covid-19 Virus?*

YesNo

Deceased - Drivers Licence, Passport or Photo ID*

Next of Kin Full Name*

First NameLast Name

Relationship to the Deceased*

Next of Kin Photo ID - Drivers Licence, Passport or Photo ID*

The person who is the Next of Kin must be the same person listed at the Hospital and or Coroner

Has the Next of Kin ever used or been known by any other name (eg: name at birth, maiden name, previous married name?)*

Next of Kin Date of Birth*

Date

Next of Kin Contact Number*

Next of Kin Email*

Next of Kin Address*

Pick up location: Name of Hospital/Nursing Home, Coroner or Residential Address*

If this is an overseas or interstate repatriation, please let us know the location the deceased will need to be sent to.*

For Overseas- Please provide an international family members name and number:*

Family member who liaised with the Coroner*

Relationship to Deceased*

Contact Number*

I authorise for the LMA Funeral Parlour to collect my family member and transport them back to Lakemba LMA Funeral Parlour to commence the burial process.*

YesNo

PLEASE NOTE: Burials that take place before the Friday Jummah Prayer, we cannot guarantee a Sheikh to be available to attend the burial. It is recommended that the family organise their own Sheikh for burials before Dhuhr prayer - Daylight and non Daylight saving times.

Would you like the LMA to request a Sheikh to attend the Funeral Service? (If your deceased loved one is a child/baby, please discuss this with the Funeral Director)*

YesNoFamily will organise their own Sheikh

Please choose which Cemetery you wish to bury your loved one*

Rookwood CemeteryNarellan CemeteryOther

Rookwood General Cemetery, Northern Cemeteries and Southern Metropolitan Cemeteries NSW are imposing a CPI increase of up to 5.1%, hence the changes in pricing.

Please be advised that the price increase is due to Rookwood General Cemetery and not the LMA. Our service fees remain the same.

Please be advised there may be additional fees for longer travel distances.

Did you purchase or do you own a grave at Rookwood or Narellan Cemetery?*

YesNo

Grave details or not applicable*

PAYMENT MUST BE MADE PRIOR TO BURIAL.

PLEASE PROCESS BURIAL PAYMENT VIA BANK TRANSFER AND REFERENCE DECEASED NAME:

National Australia Bank

Account name The Lebanese Moslem Association

BSB 082-356

Account number 359457111

Please provide transaction receipt via our email- funeral@lma.org.au

An invoice/receipt will then be issued to you.

Alternatively, payment can be made via eftpos on the day. Please prepare in advance.

Options*

Credit Card / Debit CardDirect Deposit

PLEASE NOTE: IF THE BURIAL IS FOR A REOPEN, PLEASE ALLOW 4-6 HOURS TO DIG UP THE BURIAL PLOT.

Please note: The LMA Funeral Parlour will lodge the DRS form on your behalf which is included in your burial package. You will receive an email with the editable pdf. Please fill in all details and send it back to funeral@lma.org.au

You will also receive via email your invoice|receipt and lodgement number for your reference.

For the Death Certificate, please contact Births Deaths and Marriages.

https://www.nsw.gov.au/family-and-relationships/deaths/death-certificates

Please sign to acknowledge that the information above is correct and that you give the LMA Funeral Parlour the Authority to collect the Deceased and proceed with the burial.*

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