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Funeral Home Name:

Date:

*Quote is good for 30 days

Representative:

Representative’s Phone Number:

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Sales Tax:

In decimal form. For example: 7.5% sales tax becomes .075 in decimal form

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SERVICE:

Service Charge:

Factor in Sales Tax:

YesNo

Notes:

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MERCHANDISE:

Casket:

Outer Burial Container:

Factor in Sales Tax:

YesNo

Notes:

Notes:

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OTHER:

Opening / Closing:

Miscellaneous:

Factor in Sales Tax:

YesNo

Notes:

Notes:

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