Sheboygan County Sheriff’s Department

Funeral Information Guide

The following information is confidential and provided by you voluntarily in the event of your line of duty death (LODD). Funerals can vary depending on family wishes, weather, space, and other logistics. The purpose of this form is to serve as a guide in arranging for, and conducting, a subsequent law enforcement funeral. Many issues and questions must be addressed by family, funeral home, and church and will take priority as applicable. For each question, circle your answer that is in BOLD or fill in the blanks as they apply.

Name ______Unit # ______

1.Choose one of the following regarding what type of funeral you desire. Keep in mind that this information will be sharedwith your family and the funeral director and that your family’s wishes will be paramount while using this form as a general guide.

□Ido notwish for a formal law enforcement funeral and have made separate arrangements. Please complete #2 below and disregard the remainder.

□I do notwish for a formal law enforcement funeral but welcome law enforcement presence and participation. Please complete #2 below as well as any other questions as applicable.

□I wouldlike a formal law enforcement funeral. Please complete all of the questions below.

  1. I would like the following officer(s) to act as liaison to my family and the Department:

______Alternate: ______

3.Many factors come into play, but in general, if the LODD occurs along with another officer(s), I likelyWOULD WOULD NOT wish to have services conducted jointly.

  1. Funeral home and city ______

Church name (or other) and city ______

Presiding clergy member name (or other) and city ______

5.I prefer: CREMATION CASKET BURIAL CASKET VIEWING FOLLOWED BY CREMATION

6.IWOULDWOULD NOTlike a Visitation/viewing prior to the day of the service.

If so, where? ______

7.IWOULDWOULD NOTlike a short Visitation/viewing before and on the day of the service.

8.IDODO NOTwish to be in uniform. If so, describe which uniform ______

  1. I would like the National flag to be:

DRAPED AS APPROPRIATEDISPLAYED FOLDEDNOT PRESENT

  1. I would like a Memorial Fund in the name of ______to be

donated to ______.

  1. Any special wishes (photo displays, music, mementos, etc) or other issues regarding Visitations/viewing? ______

______

______

______

______

______

  1. I would like the Service to occur at: ______

(location)

  1. List a law enforcement member you wish to participate for a eulogy if any:

______Alternate: ______

  1. Please list as it applies:

PALLBEARERS OR URN ESCORT

______Urn Bearer ______

______Escort ______

______Escort ______

______Alternate ______

______Alternate ______

______Alternate ______

Alternate ______Alternate ______

Alternate ______Alternate ______

Check if you wish to have any of the following as pallbearers/escorts:

_____SSD Sworn Honor Guard ___ Pallbearers ____Escort

_____SSD Non-Sworn Honor Guard ___ Pallbearers ____Escort

_____Other Agency Honor Guard ______Pallbearers ____Escort

(Agency)

15.As applicable, IWOULDWOULD NOTwish for a formal law enforcement procession.

16.I would like to have law enforcement presence at the Committal/Graveside:YESNO

  1. If YES, I would like the traditional Committal Rites to be conducted (National Flag formally folded, Firing Detail, Taps/Pipes, etc). YES NO
  1. I am a US Veteran and prefer the Committal Rites be conducted by:

MILITARY LAW ENFORCEMENT MILITARY & L.E. WORKING TOGETHER

Branch: ______Rank: ______Active or Retired (Circle one)

Current military memberships: ______

  1. I would like the folded flag to be presented by ______

and presented to ______.

17.I would like a second National pre-folded flag:YESNO

To be carried by ______and presented to

______.

  1. Check one:

______I would like the SSD Honor Guard to formally organize the details listed above and other issues regarding the funeral (casket posting, color guards, flag folding, hearse escort, etc.)

______I do not wish for the SSD Honor Guard’s formal assistance, but would rather have the following

person(s) assist with arrangements: ______.

19.Are there any special department mementos (i.e. your badge, etc.) you would like to be presented to someone or have donated to the department? YES NO

ItemPerson/Donated

______

______

______

  1. Please list any special instructions or wishes that are not included above:

______

______

______

______

______

______