New Jersey Administrative Code
Title 13 - LAW AND PUBLIC SAFETY
Chapter 36 - STATE BOARD OF MORTUARY SCIENCE
Subchapter 1 - ADMINISTRATION
Section 13:36-1.9 - Statement of Funeral Goods and Services Selected
Current through Register Vol. 56, No. 6, March 18, 2024
(a) When making preneed and/or at need funeral arrangements, as defined in N.J.A.C. 13:36-11.1, the practitioner shall compile a Statement of Funeral Goods and Services Selected. The statement shall be on a preprinted, single-sided sheet of paper that is at least 81/2 inches by 11 inches, but no more than 81/2 inches by 14 inches, and shall include at least the following information:
(b) Promissory notes, contracts, payment terms, and other non-related items shall not be included on the Statement of Funeral Goods and Services Selected.
(c) All charges relative to the funeral shall be categorized as follows and the Statement of Funeral Goods and Services Selected shall contain the following information:
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain the reasons in writing below.
| I. PROFESSIONAL SERVICES | |
| Basic Services of Funeral Director and Staff | $ |
| Embalming (including use of preparation room and sanitary care) | |
| If you selected a funeral that may require embalming, such as a | |
| funeral with viewing, you may have to pay for embalming. You do | |
| not have to pay for embalming you did not approve if you | |
| selected arrangements such as a direct cremation or immediate | |
| burial. If we charged for embalming, we will explain why below. | |
| Other preparation of the body | $ |
| Other (specify) | |
| Professional Services TOTAL | $ |
| II. OTHER STAFF AND RELATED FACILITIES | |
| Use of facilities and staff for: | |
| Visitation (viewing) | $ |
| Funeral Ceremony | |
| Memorial Service | |
| Use of Equipment and Staff for: | |
| Graveside Service (including accompaniment of remains to | |
| place of final disposition) | |
| Other (specify) | |
| Other Staff and Related Facilities TOTAL | $ |
| Transfer of Remains to Funeral Home | $ |
| Hearse | |
| Limousine | |
| Other (specify) | |
| Transportation TOTAL | $ |
| OPTIONAL PACKAGED SERVICES | |
| 1. Direct Cremation | $ |
| 2. Immediate Burial | |
| 3. Forwarding Remains | |
| 4. Receiving Remains | |
| |(If you select an optional package, see General Price List for a | |
| |list of included services.) | |
| Optional Packaged Services TOTAL | $ |
| IV. MERCHANDISE | $ |
| Casket or Alternative Container: | |
| Manufacturer | |
| Model | |
| Type of material | |
| Interior material | $ |
| Vault/Outer Burial Container: | |
| Manufacturer | |
| Model | |
| Type of material | |
| Other (specify) | |
| Merchandise TOTAL | $ |
| FUNERAL HOME CHARGES TOTAL (I-IV & Packaged Services) | $ |
| V. CASH DISBURSEMENTS (Estimated) | |
| Disposition: State permit and filing fees | $ |
| Certified copies of death certificate #____ @ $ _____ | |
| Cemetery or crematory | |
| Officiant and/or place of worship | |
| Music (specify) | |
| Obituary charges | |
| Other cash disbursements (specify) | |
| Cash disbursements TOTAL | $ |
| TOTAL OF ESTIMATED CHARGES (I-V & packaged services) | $ |
| GRAND TOTAL OF ESTIMATED CHARGES | $ |
IF ANY LAW, cemetery or crematory requirements have required the purchase of any of the items listed above, the law or requirement is described below:
...
Relationship to Decedent
Street Address
City, State, Zip Code
(d) A practitioner who offers the Optional Packaged Services and has that offer accepted by a consumer shall not be required to detail the charges for Categories I through III set forth in (c) above. It shall not be mandatory for practitioners to include the category of "Optional Packaged Services" on the Statement of Funeral Goods and Services Selected if they do not offer for sale the services of Direct Cremation, Immediate Burial, Forwarding of Remains, and/or Receiving of Remains, or to include the "Price Reduction" category, if this category is not utilized by practitioners. A practitioner shall not include any charges for Category V cash disbursements in any Optional Packaged Services. If a price reduction is offered, a practitioner shall disclose such reduction on the Statement of Funeral Goods and Services Selected as "PRICE REDUCTION............$."...." on the line immediately above "GRAND TOTAL OF ESTIMATED CHARGES "
(e) Immediately upon completing the Statement of Funeral Goods and Services Selected the practitioner and the consumer shall sign and date the Statement where indicated. If the consumer refuses to sign the Statement, the practitioner shall note on the signature line of the Statement that the consumer refused to sign. The practitioner shall immediately provide a copy to the person for whom the Statement was prepared.
(f) Any change, addition or deletion authorized by the purchaser after the completion of the Statement of Funeral Goods and Services Selected shall be included on the final bill.
(g) A practitioner may utilize a photocopy of the Statement of Funeral Goods and Services Selected contained in Appendix A, incorporated herein by reference, to satisfy the requirements of this section. A practitioner may fill in blank lines to customize the goods and services provided. If a practitioner does not use the chapter Appendix A, the practitioner must use a Statement of Funeral Goods and Services Selected that includes all of the required information and disclosures and follows the same basic format as the chapter Appendix A.
