Your Tribute | End-of-Life Planning and Support Resources
OBITUARY FORMAT #3
INSTRUCTIONS: Use the template below to collect information for the obituary. Next, write the obituary in the same order as the template. For more templates and sample obituaries, visit
I. ANNOUNCEMENT
Full Name: ___________________________________________________________________________
[First Name, Middle Name, Nickname, Last Name and Suffix]
Age at Death: ________________________________________________________________
[Optional]
Residence at Death: __________________________________________________________
[City and State]
Place of Death: ______________________________________________________________
[Optional]
Cause of Death: ______________________________________________________________
[Optional]
Date of Death: _______________________________________________________________
[Day of Week, Month, Date and Year]
II. LIFE
Date of Birth: ________________________________________________________________
[Month, Date and Year]
Place of Birth: _______________________________________________________________
[City and State]
Place of Residence: ___________________________________________________________
[City and State]
Parents: ____________________________________________________________________
[Mother and Father]
Marriage: ___________________________________________________________________
[Spouse, Wedding Date and Location]
Education: __________________________________________________________________
[High School, College, Trade School and Degree(s) Obtained]
Military Information: ___________________________________________________________
[Optional]
Employment: ________________________________________________________________
[Past Job, Previous Job(s), Position and Promotions]
Achievements: _______________________________________________________________
[Designations, Awards and Recognitions]
Hobbies: ___________________________________________________________________
[Interests, Activities and Sports]
Associations: ________________________________________________________________
[Fraternal, Political, Charitable and Religious]
III. FAMILY
Survivors: ___________________________________________________________________
[Spouse, Children and Spouse, Grandchildren, Great-Grandchildren, Parents, Grandparents, Siblings and Spouse, Nieces, Nephews and Other Relatives]
Predeceased By: _____________________________________________________________
[Spouse, Children, Grandchildren, Siblings and Other Relatives]
IV. FUNERAL
Funeral Service: _____________________________________________________________
[Day, Month, Year, Time and Location]
People: ____________________________________________________________________
[Officiant, Pallbearers, Honorary Pallbearers and Other Significant People]
Visitation: ___________________________________________________________________
[Day, Month, Year, Time and Location]
Reception: __________________________________________________________________
[Day, Month, Year, Time and Location]
Other Memorial: ______________________________________________________________
[Wake, Burial, Etc. Day, Month, Year, Time and Location]
Funeral Home: _______________________________________________________________
[Name and Location]
V. CLOSING
Memorial Donations: __________________________________________________________
[Organization and Location]
Thank You: _________________________________________________________________
[People and Organization Names]
Text: _______________________________________________________________________
[Poem, Hymn, Verse or Other Significant Phrase]
Closing Words: ______________________________________________________________
[Any Last Words]
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