Annual Preneed Funeral Contract Report Form

All Funeral Homes should receive a copy of the Annual Preneed Funeral Contract Report Form (green form) via U.S. Mail.

If you have more than one Funeral Home, but did not receive a form for each location, please download the form provided on the accompanying link.

The Board is making this form available online for your convenience.

 

PROCEDURE:

The Funeral Director Actually-in-Charge (AIC) submits a report form for every facility in your firm.

If there are no Preneed Contracts for a licensed facility, a signed report form must still be submitted.

The AIC attaches a CONTRACT LIST of ALL Preneed Contracts and/or Assigned Insurance Policies, and Insurance Policies Listing the Funeral Home as the Beneficiary, which were active at the end of December 31st of each year.

Preneed Contracts which were reported in the last year and previous years which are still active, must be part of this Contract List.

The Contract List must include the following information:

  • Contract Beneficiary
    - Name of individual who is the beneficiary
  • Identification
    - To whom funeral goods and funeral services are to be provided pursuant to Preneed Funeral Contract
    - Contract beneficiary’s social security number (supplying SSN is voluntary)
    - Policy number, or other form of identification
  • Balance
    - Total amount of funds associated with contract beneficiary’s account as of December 31, 2020
  • Funding Location
    - Name of insurance company, financial institution, and/or trust
    - Address of funding location
    - Trustee if applicable

You will also need to provide the TOTAL NUMBER and a TOTAL DOLLAR AMOUNT for all contracts on the report form.

The AIC will then sign the report, have it notarized, and mail the Annual Preneed Funeral Contract Report Form and Contract List to:

State of Ohio Board of Embalmers and Funeral Directors
77 South High Street
16th Floor
Columbus, Ohio 43215-6108

2020 Annual Preneed Funeral Contract Report Form
(for all contracts and policies which were still active at the end of December 31, 2020)
This form must be filed by March 31, 2021

click here for the 2020 ANNUAL PRENEED FUNERAL CONTRACT REPORT FORM