(Insert the first, middle, and last name of the decedent), who was at the age of (insert the age of decedent) when (he/she) passed away in the city (enter the city, and state of the decedents passing) on (insert the day of the week and the full date of death) (Insert the first name of decedent) was born in (Decedents place of birth) on (insert the date of decedents birth), to (Insert both decedents parents full names), (insert the decedents parents places of birth). (Insert the decedent's first name) is survived by (insert who the decedent is survived by)
