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“We are family owned and operated serving our community for more than 3 generations”

For Immediate Assistance, Please Call: (407) 880-1007

At Need Form

Use this form to provide us with as much or as little detail as you wish. At a minimum, provide us with your name and telephone number and tell us how you’d like us to work with you on the remaining information using the options at the base of the form.

Contact Person Information
Name*
First Middle Last
Address*
Street Address City State ZIP Code
County

Orange, Lake, Seminole, etc.
Email
Phone*
Cell Phone
Work Phone
Relationship to Deceased*
Deceased Person Information
Name*
First Middle Last
Sex*
Date of Birth*
Month
Day
Year
Birthplace: City, State, Country*
Marital Status*
Name of Spouse (maiden name, if wife)
In Armed Forces*
Social Security Number

The SSN is required to complete the arrangements. If you don't feel comfortable entering the information here, we will call you by telephone to retrieve the SSN.
Usual Occupation*
Kind of Business/Industry*
Education (highest completed) Elementary & Primary (0-12)*
Higher Education*
Decedent's Address*
Street Address City State ZIP Code
Decedent's County

Orange, Lake, Seminole, etc.
Decedent's Race
- White
- Asian Indian
- Native Hawaiian
- Black or African American
- Chinese
- Guamanian or Chamorro
- Filipino
- American Indian or Alaskan Native
- Japanese
- Samoan
- Korean
- Vietnamese
Parental Information
Legal forms require this information. If you do not have this information, 'Unknown' will need to be inserted.
Father's Name*
First Middle Last
Step Father's Name
First Middle Last
Mother's Name*
First Middle Last Maiden
Step Mother's Name
First Middle Last Maiden
Cemetery Information
Burial/Cremation/Anatomical Study*
Cemetery Name
Location City/Location State of Cemetery
Church Information
Church Name
Denomination
Church Address
Street Address City State ZIP Code
Church Phone
Minister's Name
First Last
Minister's Phone
Family Information
Please type in first and last names, from oldest to youngest, including spouse info for each section below. If any person is deceased, please type deceased before the respected name.
Children
Use separate line for each entry.
Grandchildren
Use separate line for each entry.
Great Grandchildren
Use separate line for each entry.
Siblings
Use separate line for each entry.
Membership in Organizations, Clubs or Societies
Organizations, Clubs, Societies: Name & Contact Information
Use separate line for each entry.
People / Groups to Notify about Funeral Services
Name of Person / Group & Email Address
Use separate line for each entry.
Comments
This field is for validation purposes and should be left unchanged.

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This heritage started 67 years ago with Pastor Herbert F. Loomis, who founded the First Baptist Church of Daytona Beach, Florida, in 1934. In 1938 Francis E. Loomis, son of Pastor Herbert F. Loomis, received his license to practice Mortuary Science and in 1941 established Loomis Funeral Home of Winter Garden, FL. read more…