Submit your webform Obituary Submission Photos may be included and should be sent in a jpg format at a minimum of 225 dpi resolution. Black and white or color photos can be used, providing the picture is of good quality and not too small. Obituaries are $60 without a photo and $65 if including a photo. A death notice, which includes only the deceased's name, date of death and funeral arrangements, is $25. Please call 879-2727 to submit payment. You may either submit this form or email the already written obituary to editor@nassaucountyrecord.com. Submitter's Name Your Email Name of Person Who May be Contacted in Case More Information is Needed: Phone Number of Contact Phone number of submitter Deceased Information Name and Age of Deceased Residence of Deceased Place and Time of Death (Day, Date) Place and Time of Death (Day, Date): Date Services (fill out all that apply) Funeral Date/Time Funeral Date/Time: Date Funeral Date/Time: Time Funeral Location Memorial Date/Time Memorial Date/Time: Date Memorial Date/Time: Time Memorial Service Location Who Officiated? Organist Soloist Interment is Where: Vigil Services/Rosary Services: Officiated by Whom? Pallbearers: About the Deceased: Date of Birth Place of birth Father's Name Father Living or Deceased? Mother's Name Mother's Maiden Name: Mother Living or Deceased? Name of Spouse (include maiden name, if applicable) Spouse Living or Deceased? If Spouse is Deceased, Date of Death When and Where Married? Career Information: Give a BRIEF description of occupation, education, military or other special honors: Other Survivors? Children's Names, Names of Spouses and Where They Live, if Applicable: Brothers and Sisters (with spouses and where they live): Number of Grandchildren Number of Great-Grandchildren Number of Great-Great-Grandchildren Preceding in Death Your image One file only.20 MB limit.Allowed types: gif, jpg, png. Memorials May Be Made To: Name of Funeral Home in Charge of Services: CAPTCHA Leave this field blank
