# Yahrzeit Information Collection Form

Collect the source facts and family practice before calculating a memorial date.

Use privately with your family. Ask permission before recording or sharing. Leave uncertain answers marked unknown.

## Source facts

1. Person's recorded name and Hebrew name: __________

2. Civil date of death exactly as recorded: __________

3. Location and time of death, if known: __________

4. Was death before or after local sunset? before / after / unknown

5. Hebrew date, if documented: __________

6. Source (certificate, inscription, family record) and transcription: __________

7. Do any sources disagree? Record each without resolving by guesswork: __________

## Family practice and reminders

1. Family practice for Adar in a leap year: __________ / needs clarification

2. Questions about first anniversary or variable month length: __________

3. Person consulted and date: __________

4. Next observance and preceding evening, once verified: __________

5. Who should receive reminders, with their permission: __________

6. Verification status and next review: __________

Created by Pinkas
Keep your completed worksheet in a private location.