Utsey Notary Services Obituary Order Form

Obituary Order Form
Sincere Condolences

Thank you for considering Utsey Notary Services during this difficult time. Please accept our heartfelt condolences for your loss. We are here to provide beautiful, respectful, and timely obituary and memorial designs to honor your loved one's memory.
Your Informtion

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name of the Deceased

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Date
Date of Death

MonthDayYear
Date
- Date
  
  MonthDayYear
  Date
  Hour MinutesAM/PM Option
- Service Location
  
  Name of the Church
  
  Street Address
  
  CityState / Province
  
  Postal / Zip Code
- Interment (Cemetery) - Only if Applicable
  
  Cemetery Name
  
  Street Address
  
  CityState / Province
  
  Postal / Zip Code
- Funeral Home Information - Only if Applicable
  
  Funeral Home
  
  Street Address
  
  CityState / Province
  
  Postal / Zip Code
- Repass Information - Only if Applicable
  
  Location Name
  
  Street Address
  
  CityState / Province
  
  Postal / Zip Code
- Funeral Home and/Church Logo
  
  Only if Applicable
  Cancelof
- Digital & Visual Announcement Services
  
  Share the news of a loved one’s passing or service details with grace and ease through custom-designed digital announcements. Each piece is personalized with music, high-quality visuals, and thoughtful design, perfect for email, text, or social media sharing.
  
  Whether you’re announcing a recent passing, sharing memorial service information, or honoring a life well lived, we offer professional and compassionate design services to help you inform loved ones in a beautiful way.
- Basic Digital Announcement – $55
- Service Details Announcement – $65
- Enhanced Visual Announcement (with Music) – $85
- Select your Digital Service(s) Announcement Verbiage
  Please Choose one (Only if Applicable).
- Full Announcement Suite – $145
- Select your Digital Announcement Verbiage
  Please Choose one (Only if Applicable).
- Please Read Before Selecting Your Program
  
  📧 Estimate & Payment Link
  After you submit this form, you’ll receive an email with a full estimate and a secure Square payment link.
  💳 Deposit Requirements
  50% deposit for print-based orders
  Full payment upfront for digital-only or orders under $100
  ⏱️ Timeline
  Proof delivered within 2–3 business days (rush available)
  Final balance due before your project is sent to print
  🚫 No Print Without Approval
  Your project will not proceed to printing until you have approved the final draft and your balance is paid in full.
- Select Template Option
  
  No-Fold programs 5.5” x 8.5”Bi-fold 4 Page programs 8.5”x11”Bi-fold 8 Page programs 8.5”x11”Bi-fold 12 Page programs 8.5”x11”Bi-fold 4 Page programs 11"x17" (Folds to 8.5"x11")Bi-fold 8 Page programs 11"x17" (Folds to 8.5"x11")Bi-fold 12 Page programs 11"x17" (Folds to 8.5"x11")Tri-Fold Programs 8.5”x14” (Folds to 4.75”x8.5”)
- Quantity
  (Only if Applicable).
- Select Template Option
- Matte or Gloss Program Finish (There are no additional cost for finish)
  
  MatteGlossy
- Optional Add-On: Song or Video Tribute (via QR Code)
  
  Would you like to include a song or tribute link in your printed program? A custom QR code can be added that guests can scan to hear a special song (e.g., from YouTube) or view a memorial video.
- Options:
  
  Code (link only): $15Styled QR Code (color-matched or branded): $25
- A valid YouTube or video link must be provided. The QR code will be tested and embedded directly into the design layout: Paste your song or video link here:
- Collage Design Notice
  
  Please note that the visual examples provided in this form are for reference only and may not be used in the final design. Collage templates will be selected based on your chosen collage package and the photos you provide. I may apply customizations such as names, florals, or other design elements to ensure the collage complements the overall program design.
- Select a collage package based on the number of photos you’d like to include (Optional)
  
  Small (1–3 photos) – $45Standard (4–6) – $65Deluxe (7–10) – $85Legacy (11–15) – $105Extended (16–20) – $125Custom (21+) – Starting at $150
- Please Upload Obituary Cover Photo (Photo of the Deceased)
  
  Cancelof
- Who will Read/Deliver the Obituary
  Only if Applicable
- Obituary Information
  Only If Applicable
- File Upload: Optional – to attach Obituary Document(s)
  
  Only if Applicable
  Cancelof
- Who will deliver the Eulogy or Words of Comfort?
  Only if Applicable
- Eulogy Information
  Only If Applicable
- File Upload: Optional – to attach Eulogy Document(s)
  
  Only if Applicable
  Cancelof
- List any soloists or musical performers
  Only if Applicable
- Song Name and/or Song Lyrics
  Only if Applicable
- File Upload: Optional – to attach Song Lyric Document(s)
  
  Only if Applicable
  Cancelof
- List any Poem Readers
  Only if Applicable
- List any poems or readings (Title and/or Author)
  Only if Applicable
- File Upload: Optional – to attach actual Poem/Script Document(s)
  
  Only if Applicable
  Cancelof
- Acknowledgments & Special Thanks
  Only If Applicable
- File Upload: Optional – to attach Acknowledgment document(s)
  
  Only if Applicable
  Cancelof
- List any special elements such as candle lighting, military honors, dove release, etc.
  Only If Applicable
- How would you like to provide the Order of Service?
  Please Choose one (Only if Applicable).
- Upload the provided Order of Service
  
  Only if Applicable
  Cancelof
- Please select the elements you’d like to include in the Order of Service - Select those that apply.
  
  Pastor / Officiant WelcomeOpening PrayerScripture Reading (Old Testament)Scripture Reading (New Testament)Soloist PerformanceChoir or Group SelectionInstrumental MusicPoem or ReadingAcknowledgments / ResolutionsTribute from FamilyTribute from Friends / ColleaguesObituary ReadingSilent Reading of ObituaryEulogyWords of Comfort / Homily / MessageFinal ViewingBenediction / Closing PrayerRecessional / Final Song
- Comments & Notes
- Memorial Prayer Cards
  
  Size: 2.5”x4.25”Matte FinishGloss FinishLaminated Finish
- Memorial Prayer Cards Quantity
  (Only if Applicable).
- Memorial Prayer Cards
  
  Size: 4”x6”Matte FinishGloss FinishLaminated Finish
- Memorial Prayer Cards Quantity
  (Only if Applicable).
- Memorial Bookmarks (2.5”x8.5”)
  
  MatteGlossSilver Tassel (Optional) $.50 eachGold Tassel (Optional) $.50 each
- Bookmarks Quantity
  (Only if Applicable).
- Memorial Poster (20”x30”)
  
  Poster Only (Rolled) $100Foam Board $130Framed $150Easel/Stand (Will be provided with Estimate) $40-$50Proof Only $30
- Poster Quantity
  (Only if Applicable).
- Memorial Fans (8”x12” with handle) Front/back
  
  130lb Matte110lb Gloss card stock
- Fans Quantity
  (Only if Applicable).
- Memorial Buttons (3”x3”)
- Buttons Quantity
  (Only if Applicable).
- Funeral Guest Book (Collect signatures, messages, and memories) $125 Each. Optional-Pen & Stand (Additional $20)
  (Only if Applicable).
- Upload Any additional Document(s)/Image(s)
  
  Cancelof
- Delivery Date
  
  MonthDayYear
  Date of anticipated delivery.
- Shipping cutoff:
  
  Order On: Monday Free Shipping Arrives: Wednesday Overnight by Noon: Tuesday  First Overnight: Tuesday 10AM
  Tuesday Thursday Wednesday Wednesday 10AM
  Wednesday Friday Thursday Thursday 10AM
  Thursday Monday Friday Friday 10AM
  Friday   Tuesday   Monday   Monday 10AM
  Saturday   Wednesday Tuesday Tuesday 10AM
  Sunday Wednesday   Tuesday Tuesday 10AM
- Choose your delivery speed:
  Orders placed before 12PM CST (Mon–Fri) ship same day. Orders after 12PM ship the next business day.
- Name of Business and/or Delivery Recipient
  Please include
- Delivery Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Terms & Acknowledgment
  
  By submitting this form, I confirm that all information provided is accurate to the best of my knowledge. I understand that this form serves as an official intake for obituary program design services, including any selected templates, collages, add-ons, or customization requests.
  
  Once the form is submitted, a personalized price quote based on selected services will be emailed to me. This quote will include an option to submit payment via Square — either as a deposit (50%) or full payment, depending on the package and urgency of the service.
  
  I understand that work on my project will not begin until the required deposit or full payment is received. Deposits are non-refundable once design work has started. All final balances must be paid before the final product is delivered.
  
  I acknowledge that rush services, custom requests, or additional revisions may result in extra charges, which will be clearly communicated and added to the final balance if applicable.
- I have read and agree to the Terms of Service above.
  
  By checking this box, you acknowledge that a personalized quote will be provided, and work will commence upon receipt of payment via Square.
- Should be Empty: