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名字 Name of Dedicator

祖先4个姓氏 Please state the 4 surnames of your ancestors.

For 单身 singles：（1.祖父姓氏 Paternal Grandfather，2.祖母姓氏 Paternal Grandmother，3.外祖父姓氏 Maternal Grandfather ，4.外祖母姓氏 Maternal Grandmother）

For 夫妻 couples: （1.男方父亲氏 Husband's father，2. 男方母亲氏 Husband's mother，3.女方父亲氏 Wife's father， 4.女方母亲氏 Wife's mother）

地址(会将贴在蜡烛上) Address (To be placed on candle)：

红牌 Red tablet

名字 To be Dedicated to:

如果您在今世有已经过世的父母亲，请填写这部分 Please fill this section if you have deceased parents of this lifetime

阳上 Name of Dedicator

往生者 Name of Deceased Parent:

1) 大尺寸合家消灾祈福红牌、四姓祖先及冤亲债主超度、今生往生父母、过去七世父母、六道众生超度牌位以及其他标准尺寸超度牌位

Large-size Family Red Tablet, Ancestral & Karmic Creditor, Parents of this Lifetime, Past 7-Lifetime, Sentient Beings of Six Realms Yellow and other standard size liberation tablets

2) 一份九盏灯1 set of 9-Lamp Offering

3) 药品、食物和金银纸Medicine, Food & Joss Papers

4) 免费6个月的佛堂超度和祈福牌位 Free 6 months Yellow & Red Tablet @ Buddhist Prayer Hall