ASBFD&E - Blue Booklet Sec 5

Terms in this set (86)

This prearranged funeral agreement is for the future funeral arrangements of (name of beneficiary) . The payments you make under this prearranged funeral agreement will be deposited in trust account number ____________ at the (office or branch) of the(name of financial institution) . Written notice will be mailed to you if this account is transferred to another financial institution. That notice will include the name and location of the financial institution and the new trust account number. The total monies intended to be deposited in this trust account over the term of the agreement is $______________. An initial service fee of $________ has been charged which will be paid to this funeral establishment. If this agreement is canceled, any portion of the initial service fee which has not been paid under the agreement is no longer due and payable to the establishment. An annual service fee of ________% of the annual accrued interest on the funds in the trust account will also be charged for administrative and accounting expenses. If you wish to cancel this agreement, you must give the funeral establishment a written request to cancel before the trust funds will be refunded. If you cancel this agreement within three business days after signing this agreement, all monies paid, including all service fees, will be refunded to you. If remaining trust funds exist after performance of this agreement, those funds will be refunded to the estate of the beneficiary. The prices of the funeral goods and services you have requested will be the prices in effect at the time of the future funeral arrangements.This prearranged funeral agreement is for the future funeral arrangements of (name of beneficiary) . The payments you make under this prearranged funeral agreement will be deposited in trust account number ____________ at the (office or branch) of the(name of financial institution) . Written notice will be mailed to you if this account is transferred to another financial institution. That notice will include the name and location of the financial institution and the new trust account number. The total monies intended to be deposited in this trust account over the term of the agreement is $______________. An initial service fee of $________ has been charged which will be paid to this funeral establishment. If this agreement is canceled, any portion of the initial service fee which has not been paid under the agreement is no longer due and payable to the establishment. An annual service fee of ________% of the annual accrued interest on the funds in the trust account will also be charged for administrative and accounting expenses. If you wish to cancel this agreement, you must give the funeral establishment a written request to cancel before the trust funds will be refunded. If you cancel this agreement within three business days after signing this agreement, all monies paid, including all service fees, will be refunded to you. If remaining trust funds exist after performance of this agreement, those funds will be refunded to the estate of the beneficiary. The prices of the funeral goods and services you have requested will be the prices in effect at the time of the future funeral arrangements.Purchaser initials________
1. Pays the prescribed application fee pursuant to section 32-1309.
2. Provides the applicant's full name and current address, a recent photograph, any prior names or aliases, all prior addresses for the immediately preceding seven year period and the date and location of the applicant's birth.
3. Declares that the applicant has not been convicted of any felony or convicted of any other crime involving dishonesty, fraud, deception, misrepresentation, embezzlement or breach of fiduciary duty in any state or federal court within the seven year period immediately preceding the date of application.
4. Declares that the applicant has not been the subject of a consumer fraud, securities fraud or civil racketeering judgment or consent order in any state or federal court within the seven year period immediately preceding the date of application.
5. Provides satisfactory evidence of employment or engagement or of an offer of employment or engagement by a funeral establishment holding a prearranged funeral sales endorsement issued pursuant to this article.
6. Achieves a written score of at least seventy-five on a written examination conducted by the board on the provisions of this chapter and the rules adopted pursuant to this chapter.
7. As each applicant is registered by the board, the funeral establishment shall show evidence that the bond required under section 32-1391.12 has been increased by five thousand dollars for the applicant.
8. Submits a completed fingerprint card and the prescribed fingerprint background check fee to the board.
9. Provides any other relevant information reasonably required by the board.
1. The names and addresses of persons who were sold prearranged funerals funded by trust by the funeral establishment during the preceding calendar year, the names of the persons who are to be the beneficiaries of the prearranged funerals and the name of the registered salesperson selling each prearranged funeral.
2. The total contract amount for each purchaser listed in paragraph 1, the total monies previously paid on each contract and the monies paid by and refunded to the purchaser on each contract during the preceding calendar year.
3. The total trust funds contained in the funeral establishment's prearranged funeral trust accounts as of the end of the preceding calendar year and the total funds received in the trust accounts during that year.
4. The total monies, if any, received from purchasers but not deposited in the trust accounts as of the end of the preceding calendar year, excluding initial service fees received by the funeral establishment.
5. The names, registration numbers and addresses of all salespersons employed or otherwise engaged by the funeral establishment during the preceding calendar year and the names and registration numbers of all salespersons terminated during that year.
6. The names and addresses of the financial institutions where the trust funds are on deposit and the account number of each account.
7. A statement of the owner of the funeral establishment that the establishment has complied with this article and rules adopted pursuant to this article.
8. Other information required by the board.
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