Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 65 - BOARD OF FUNERAL DIRECTORS AND EMBALMERS › Chapter 30 - REGULATIONS FOR PRENEED FUNERAL PLANNING › Part VIII - Required Content of Contracts and Disclosures › Section 18VAC65-30-220 - Content of preneed contracts

Current through Register Vol. 40, No. 24, July 15, 2024
The following information shall be contained in any
					 contract for preneed funeral planning.
Date: ______________________________
Contract: ______________________________
PRENEED FUNERAL CONTRACT
for
(Name of Recipient of Services)
______________________________
__________________________ (Zip)________
I. SUPPLIES AND SERVICES PURCHASED
If goods and services are guaranteed and your contract is
					 fully paid or funded at the time of your death, no additional cost will incur
					 for your family or estate even though the actual prices of goods and services
					 may increase between the date of this contract and the time of need. (Please
					 see the disclosure document.)
If goods and services are nonguaranteed, your family or
					 estate may incur additional costs for goods and services as the prices for
					 these items may increase from the date of the contract to the time of
					 need.
Cash advance items are not guaranteed. A cash advance item
					 is any item obtained from a third party by the funeral home on your behalf.
					 Cash advance items may include cemetery or crematory services, pall bearers,
					 public transportation, clergy honoraria, flowers, musicians or singers, nurses,
					 obituary notices, gratuities, and death certificates.
Charges are only for those items that you selected or that
					 are required. If we are required by law or by a cemetery or crematory to use an
					 item, we will explain the reasons in writing below. If you selected a funeral
					 that may require embalming, such as a funeral with a viewing, you may have to
					 pay for embalming. You do not have to pay for embalming you did not select if
					 you select arrangements such as a direct cremation or immediate burial.
Guaranteed Services Purchased
I. BASIC SERVICES OF FUNERAL DIRECTOR AND
								STAFF
$_________
II. FUNERAL HOME FACILITIES
A. Facilities and Staff for
								visitation/viewing
$_________
B. Facilities and Staff for funeral ceremony
$_________
C. Facilities and Staff for memorial service
$_________
D. Equipment and Staff for graveside service
$_________
(NOTE TO FUNERAL HOME: If you have additional
								charges such as facilities and staff for home/church viewing, or a charge for
								additional staff person or through calculation of manhours, etc., add here as
								extra items. If you have a charge for equipment for interment, add
								here.)
III. EMBALMING
A. Normal remains
$_________
B. Autopsy remains
$_________
IV. OTHER PREPARATION OF THE BODY
$_________
(NOTE: List all items that you placed under Other
								Preparation on your General Price List.)
V. IMMEDIATE BURIAL
$_________
VI. DIRECT CREMATION
$_________
VII. TRANSFER OF REMAINS TO FUNERAL
								ESTABLISHMENT
$_________
VIII. FORWARDING REMAINS TO ANOTHER FUNERAL
								HOME
$_________
IX. RECEIVING REMAINS FROM ANOTHER FUNERAL
								HOME
$_________
X. AUTOMOTIVE EQUIPMENT
A. Hearse
$_________
B. Limousine
$_________
(NOTE: List all others that you placed on General
								Price List.)
XI. FUNERAL MERCHANDISE
A. Casket (*describe)
_________________________________
_________________________________
$_________
B. Outer Burial Container (*describe)
_________________________________
_________________________________
$_________
C. List any others
_________________________________
$_________
Supplies Purchased
Clothing
$_________
Temporary marker
$_________
Acknowledgment cards
$_________
Register/attendance books
$_________
Memorial folders
$_________
Other
$_________
SUBTOTAL COSTS OF (GUARANTEED) SUPPLIES
								PURCHASED:
$_________
XII. PACKAGE PRICES
(NOTE: List all package prices by name.)
SUBTOTAL COSTS OF (GUARANTEED) SUPPLIES
								PURCHASED:
$_________
Nonguaranteed Goods and Services Purchased
The actual prices of goods and services below are
								NOT GUARANTEED. These items may include obituary notices, death certificates,
								cemetery fees, flowers, sales tax, etc. The prices are estimated and the
								estimates will be included in the Grand Total Contract Price. The differences
								between the estimated prices below and the actual cost will be settled with
								your family or estate at the time of need:
SUBTOTAL ESTIMATED COSTS OF NONGUARANTEED
								ITEMS:
$________
GRAND TOTAL FOR PRENEED ARRANGEMENTS
1. Total cost of (guaranteed) services
								purchased
$_________
2. Total cost of (guaranteed) supplies
								purchased
$_________
3. Total estimated cost of nonguaranteed
								items
$_________
GRAND TOTAL
$_________
The only warranties, express or implied, granted in
								connection with the goods sold in this preneed funeral contract, are the
								express written warranties, if any, extended by the manufacturers thereof. No
								other warranties and no warranties of MERCHANTABILITY OR FITNESS FOR A
								PARTICULAR PURPOSE are extended by the (funeral home)
								____________________.
GENERAL INFORMATION
In order that the Buyer may understand the
								relationship of all parties involved in this preneed arrangement and contract,
								the following is provided:
A. Buyer:
B. Funeral Home Providing Services:
C. Contract seller:
Employed by: (Funeral Home)
Virginia Funeral Director or Funeral Service
								Licensee License Number:
II. METHOD OF FUNDING
A. Trust.
The following information will be given if a trust is used
					 to fund this agreement:
1. Amount to
				  be trusted:
2. Name of
				  trustee:
3. Disposition of
				  Interest:
4. Fees, expenses, taxes
				  deducted from earned interest:
5.
				  Buyer's responsibility for taxes owned on interest: