BCPFFA FUNERAL SUBMISSION FORM

If your local experiences a loss of an active, retiree, and/or in the Line of Duty, please advise the BCPFFA office by. using this form below so we can assist in communicating the service details. For Line of Duty Deaths (LODD), please contact 6th District Vice President and/or fill out this IAFF submission form.

Funeral Submission Form

LOCAL REPRESENTATIVE INFORMATION

Fire Department City

Local Number

Your Name

First Name

Last Name

Your Title

DECEASED INFORMATION

Name of Deceased

First Name

Last Name

Type of Passing

Active Member

Retired Member

Line of Duty Death (LODD)

Funeral Place Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Donations in Lieu of Flowers

Yes

Designated Charity

Expressions of Sympathy sent to:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

ADDITIONAL INFORMATION

Information for Members Attending

ie. Muster time; Wake; Location

Comments for BCPFFA

BCPFFA FUNERAL SUBMISSION FORM

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