Travel Plan Enrollment Form

Membership Benefits Include

Contacting a licensed funeral home or professional embalming service center near the place of death
Transporting the deceased from the place of death to the funeral home or service center for preparation
Preparation of the deceased for transport
Securing all documentation for shipping including one death certificate
Placing the deceased in appropriate shipping container
Arranging for transportation to their local funeral home

In the event of death of a Participant who is 75 miles or more away from his or her legal residence at the time of death, the Travel Plan by Inman will render assistance, including locating a local, licensed funeral home, mortuary or direct disposition facility, arranging and paying for the transportation of the body from the site of death to the licensed funeral transport, purchasing the minimally necessary casket or air tray for transportation, arranging for the transportation to local funeral home and securing all documentation including one death certificate.

Return of remains services are provided by Inman Shipping Worldwide when Participants are traveling 75 miles or more from their legal residence* or in another country which is not the country of residence. All services MUST be arranged by Inman Shipping Worldwide NO claims for reimbursement will be accepted. Enrollment in the Travel Plan by Inman is not valid until payment has been received by the Travel Plan Administrative Center and an enrollment number has been issued to the purchaser.

“Legal residence,” for purposes of the Travel Plan, shall mean the participant’s fixed and full-time place of abode. The Travel Plan may require verification of a participant’s legal residence through requests for documentation or information evidencing the residence of the participant at the time of, and prior to, the participant’s death. Notwithstanding the foregoing, if a participant physically lives at an address for a period of 180 days or more within the twelve (12) month period prior to the participant’s death, that address, as opposed to the current legal address identified above, will be considered the participant’s legal address. A nursing home will be deemed a participant’s legal residence if the participant stays at the nursing home for a period of 180 days or more.

If Participant enrolls in the Travel Plan while Participant is away from his or her legal residence, the plan of assistance will not become effective until the Participant has returned to his or her legal residence for subsequent travel.

Travel Plan does not cover medical tourism.

In order to provide you and your family the very best customer service, we encourage you contact our Travel Plan Service Center and let us know of any upcoming international travel. Your Travel Plan purchase is good for unlimited international travel.

Service For

Individual Plan

$499

Couple Plan

$998

Participant 1

First Name

Middle Name

Last Name

Gender

Date of Birth

Contact Phone #

Current Legal Address

Street

City

State

Zip

Mailing Address (if different than your legal address)

Street

City

State

Zip

Participant 2

First Name

Middle Name

Last Name

Gender

Date of Birth

Contact Phone #

Payment Options

$450 Paid in full

$150 (3) Monthly payments

$37.50 (12) Monthly payments

Deduct on the day of the month if using payment plan option.

If participant is paying for the Travel Plan by Inman with monthly payment option and passes away, the remaining payments are forgiven and the member receives the fulfillment of their Travel Plan.*

*Plan is fulfilled with forgiveness as long as participant is current with their monthly payment.

Payment Information

Payment Method

Credit/Debit Card

E-Check

Credit Card Number

Expiration Date

CVC

For all customers, the temporary authorization charge is $1.00 USD. Our verification provider doesn’t proceed with the charge, and the charge should disappear within three to five business days. The authorization charges for prepaid credit cards might vary and most prepaid cards are not supported for payment plans.

Note: If your bank displays charges in a currency other than USD or INR, the small charge might show on your statement as a different amount because of currency conversion. It’s also possible for some financial institutions to take more than 5 business days to release the temporary hold, please allow up to 15 days before notifying our office. Thanks!

Confirm & Pay

I/we, the participant(s), agree to the Terms outlined above.