Enquiries(08) 9381 7022
Registration Form

Information Must Be Filled in to the Best of Your Knowledge
Missing Information will Show as Unknown on the Death Certificate

Surname
Surname Alias
All Given Names
All Given Names Alias
Date of Death
Sex
Place of Death
(Name of the place / hospital / nursing house E.g. RPH)
Address of the Death Place
Building Name
Residential Address
Suburb of Birth
State
Country
Date of Birth
Age
Usual Occupation during working life
Residency in Australia  (if born overseas)
Year of Arrival
Number of yrs
Aboriginal or Torres Strait Islander Origin
Religion
Pacemaker

DETAILS OF MARRIAGES (to whom the deceased is married to)    All Marriages Must go on Death Certificate 1st to Last Marriage
Give full name (inc Surname the day prior to the marriage)
Surname
All Given Names
Date of Marriage
Unknown
Place (Suburb/State/Country)
Date of Marriage
Unknown
De facto's All Given Names
Surname

CHILDREN'S DETAILS    All Children of the Deceased Must go on Death Certificate (Oldest to Youngest in Age Order)
All Given Names
Date of Birth
Unknown
Age
Unknown
Deceased
Sex
Date of Birth
Unknown
Unknown

PARENTS OF THE DECEASED    Is Required to go on the Death Certificate
Father's Surname
Given Name(s)
Occupation During Working Life
Mother's Surname
Maiden Surname
Given Name(s)
Occupation During Working Life

Coroner's
Doctor's Name, Dr
Date last seen alive
Please note Non Attended Cremations take place at Karrakatta
Grave Area
Section
Number
Grantee's Name
Name of Previous Internment
Grant #

ADMINISTRATOR, PERSON ARRANGING THE FUNERAL (signing the forms for the family)
Surname
Given Names
Relationship
Email
Address
Contact Number
2nd Contact Name
Relationship
Email
Contact Number
Minister/Celebrant
Email
Contact Number

Our packages have no hidden fees and are inclusive of GST.
Our packages have no hidden fees and are inclusive of GST.

Simple Price-Wise Cremations
CALL US: 08 9381 7022
Simple Price-Wise Cremations
CALL US: 08 9381 7022

Barry from Nollamara


Simple Price-Wise Cremations have conducted two cremation services for my family.

On both occasions I found them to be professional, very courteous, efficient and caring.

They prepared and presented a lovely memorial pictorial presentation. I would have no hesitation in recommending SPW Cremations.