Obituary Form Obituary Form If you are human, leave this field blank. Name of Person Date of Birth Date of Death Age Service Location Service Time Personal Information Survivors Photo (Optional) Drop a file here or click to upload Choose File Maximum upload size: 516MB Your Name Your Contact Email/Phone Payment Obituary Submission ($100.00) After clicking “Submit”, you will be redirected to PayPal to complete the payment process with a debit/credit card or your PayPal account.