Payment Center

Please accept our condolences if you have just experienced the loss of a loved one. This payment center is for use to pay the balance of the selected cremation package or to purchase additional items such as extra death certificates or cremation merchandise. If you wish to become a member to receive discounted cremation options, please visit our Arrange Online page to make your selections for Pre Planning, Become a Member or immediate need in A Death has Occurred online arrangement centers.

 Contact Information
Deceased's First Name (if applicable):
Deceased's Last Name (if applicable):
Your First Name: *
Your Last Name: *
Street Address: *
City: * State: * Zip: *
Country:
Phone Number (Daytime): *
Cell Phone Number:
E-mail Address: *

 Payment Information

Amount to Pay: * $
Payment for: *
Tri-State Membership Number:

 Comments (Optional)

 Billing Information
Name On Card - First name:
Name On Card - Last name:
Card Type: *
Card Number: *
Exp Date: * /
Card Security Code: * What is this?