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Statement of Funeral Goods and Services Selected I am interested in membership only. Enclosed is my completed Membership Registration form. I understand I will be receiving my Simple Traditions Lifetime Membership card in the mail shortly. Simple Traditions. Please send me the trust documents reflecting the selections made below. I am also enclosing my completed Membership Registration form and the trust payment indicated below. Signature Basic Cremation Service with release to family non-guaranteed 799. 00 1 050. 00 Additional Services add charge to above total Scattering at sea or Nevada Mountains without family present 325. 00 Delivery of cremated remains in standard container within 30 mile radius Shipment of cremated remains anywhere in the United States this includes preparation container postage paid registered mailing with return receipt requested through the United States Postal Service 75. 00 Additional funds price not guaranteed for items such as death certificates or merchandise items. TOTAL Monthly payment selection Payment in full Non Guaranteed Plan -the total price of the plan shall be based on the current cost of the services at the date of the beneficiary s death based on the then current price list. Guaranteed Plan* The total price of the Plan is the current cost of the services set in the Plan 950. 00. Your price will not change and is guaranteed as long as all payments are made as required by the Agreement. Both accounts accrue interest however the guaranteed plan allows for any excess interest to go to funeral director at the time of death. Simple Traditions. Please send me the trust documents reflecting the selections made below. I am also enclosing my completed Membership Registration form and the trust payment indicated below. Signature Basic Cremation Service with release to family non-guaranteed 799. 00 1 050. 00 Additional Services add charge to above total Scattering at sea or Nevada Mountains without family present 325. Signature Basic Cremation Service with release to family non-guaranteed 799. 00 1 050. 00 Additional Services add charge to above total Scattering at sea or Nevada Mountains without family present 325. 00 Delivery of cremated remains in standard container within 30 mile radius Shipment of cremated remains anywhere in the United States this includes preparation container postage paid registered mailing with return receipt requested through the United States Postal Service 75. 00 Delivery of cremated remains in standard container within 30 mile radius Shipment of cremated remains anywhere in the United States this includes preparation container postage paid registered mailing with return receipt requested through the United States Postal Service 75. 00 Additional funds price not guaranteed for items such as death certificates or merchandise items. 00 Additional funds price not guaranteed for items such as death certificates or merchandise items. TOTAL Monthly payment selection Payment in full Non Guaranteed Plan -the total price of the plan shall be based on the current cost of the services at the date of the beneficiary s death based on the then current price list.

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