"*" indicates required fields Your Experience With Loss.*Has anyone close to you passed away in the last five years? Yes No Your Own Final Wishes*Which would you prefer for yourself? (Please select the closest option) Burial Cremation Something else I don’t know The Price Tag*How much do you estimate a funeral or cremation would cost in your area $3,000 $5,000 $7,000 $10,000 $15,000 Don't know The median cost of a funeral is $9,420. For cremation it totals $6,970. That doesn’t include additional cemetery or service costs which can add $2,000 - $5,000 or more. (Source: NFDA, 2021) Government Benefits*Do you expect to receive any Government death benefits? Yes No Most people qualify for a $255 federal government death benefit. (Source: socialsecurity.gov, 2023) Who Will Be in Charge?*Who will be the main person responsible for your funeral arrangements? Spouse or Partner Daughter or Son Other Don't know / Haven’t decided Who Will Pay for It?*How will you cover the costs of your funeral or other final arrangements? Please choose the best one if more than one apply. Savings Family Members Church or charity Life Insurance Other Don't Know Aid for U.S. Seniors*Would you like to find out if you qualify for the Funeral Advantage Life Insurance Program and receive My Final Wishes Organizer? Nearly 1,000,000 families across America are currently participating in this program. Yes No This field is hidden when viewing the formutm_sourceThis field is hidden when viewing the formutm_mediumThis field is hidden when viewing the formUTM_TermThis field is hidden when viewing the formutm_contentThis field is hidden when viewing the formutm_campaign
