Yoder-Culp Funeral Home
1911 South Main St.
Goshen, IN 46526

Pre-Planning Form

More people are recognizing that pre-planning a funeral demonstrates love and consideration for their family members. It is a thoughtful decision that reduces the stress of indecision and uncertainty when a death occurs.

Some plan ahead because there will be no one who is capable of making responsible decisions. Others have definite preferences concerning their funeral service, and they want their families to be informed and involved in those decisions.

Many people pre-arrange because they like the peace of mind knowing there will be adequate funds to cover funeral expenses. Also, pre-payment can provide you real benefits when applying for Medicaid.

Most importantly, pre-arrangement guarantees that your family is relieved from the emotional as well as the financial burden of making funeral arrangements at the time of a family crisis.

Our pre-planning specialist, Philip Fought, (philip.fought3@gmail.com) will guide you through the process and provide valuable information to assist you in making those difficult decisions. You simply pay today’s price for your funeral either by single or multiple payments over several years. A contract is made with Yoder-Culp Funeral Home guaranteeing services and merchandise and the money is held until your death in a state regulated insurance irrevocable trust. This money is not accessible by us until after your death. When we provide services, we will submit the claim to your trust for payment.

Other benefits of a preplanned funeral trust are:

  • We guarantee your funeral and it will be provided as you selected regardless of future inflation.
  • Our funeral trust is tax exempt. If you are saving for your funeral in a savings or other investment account, you will pay taxes on the interest. Our trust saves you from this.
  • Our funeral trust is portable so if you move in the future, your preplanned funeral can move with you. It can be paid to any funeral home in the United States that you choose.
  • Our funeral trust allows you to pass additional assets to your spouse and children. When you have a prepaid funeral, your life insurance and life savings can pass directly to your survivors and they will not have a funeral bill to pay.
If you would like to know more, please fill out the on-line pre-planning form below or contact us at
 (574) 533-3153 or ycfunlhm@maplenet.net or by contacting Phil Fought directly at philip.fought3@gmail.com.

I am planning for:
Personal Information
Email Address:
Zip Code:
Phone Number:
Place of Birth:
Date of Birth:
Marital Status:
Spouse (Maiden Name):
Father's Name:
Mother's Maiden Name:
Religous Preference:
High School Name:
# of Years:
College Name:
# of Years:
Family Information: Please list the names of survivors and state their relationship to you, their spouse's names and the city in which they live as you wish to have them listed in the memorial. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, Others (Eg. Son: Joe Smith and his wife Paula of Milledgeville)
Preceded in Death by:
Additional Information and Organ:
Work History
Number of Years:
Years Retired:
Military Service
Service Branch:
Serial Number:
Date Enlisted:
Rank at Discharge:
Date Discharged:
Discharge on File At:
Combat Action:
Funeral Preferences
I prefer my Funeral Service to be
Place of Service:
I prefer


For security, please enter the letter or number displayed in the corresponding box below each character. The letters do not have to be capitalized