Funeral Costs Documentation

Deceased Person Details

Full Name
Date of Birth
Date of Death
Policy Number

Claimant Details

Full Name
Relationship to Deceased
Contact Number
Email
Address

Funeral Service Provider

Company Name
Contact Person
Contact Number
Address

Funeral Costs Breakdown

Description	Cost
Coffin/Casket
Funeral Service
Burial/Cremation Fees
Transport
Other Expenses
Total

Supporting Documents

• Invoice(s) from service provider(s)
• Death certificate
• Proof of payment