Get 5184020785 Form

Filling out the 5184020785 Form online can seem daunting, but with careful guidance, you can complete it efficiently and accurately. This guide will provide you with systematic instructions for each section of the form to ensure that your complaint is properly filed.

Follow the steps to complete the 5184020785 Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor for easy digital completion.
2. Enter your personal information in the 'Complainant' section. This includes your name, street address, city, state, ZIP code, and both daytime and evening phone numbers.
3. Indicate your relationship to the decedent by selecting one of the available options such as 'Agent', 'Parent', 'Spouse', or 'Friend'.
4. Provide detailed information about the funeral home or director involved. This includes their name, street address, phone number, and the relevant details of the decedent, such as their name, place of death, date of death, and date of the transaction.
5. Clarify the cost of the funeral expenses and indicate whether the expenses were prefunded by selecting 'Yes' or 'No' and specifying the type of preneed agreement if applicable.
6. In the payment section, check all applicable payment methods like cash, check, credit card, or insurance assignment, and indicate if you signed a contract, with details of where and when.
7. Document your interactions with the funeral home regarding your complaint. Include the nature of your contact, who you spoke to, and the nature of their response.
8. Specify if the matter has been submitted to another agency or attorney, or if court action is pending. Provide necessary details if applicable.
9. Outline the nature of your complaint by checking relevant boxes and providing any additional comments on a separate sheet if needed.
10. List any other funeral homes or directors involved in the situation, providing their contact information and license number where applicable.
11. Identify any witnesses to the matter with their names and contact details.
12. State the form of relief you are seeking, such as an exchange, repair, or reimbursement.
13. Lastly, review your completed form for clarity and accuracy, attach copies of any important documents, and submit it to the Bureau of Funeral Directing at the provided address.

Take the first step in addressing your complaint by filling out the 5184020785 Form online today.