Cremation Authorization - Lower Mainland Cremation

Cremation Authorization

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Complete Vital Stats
Complete Required Forms
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Deceased Name(Required)

Date of Death(Required)

Place of Death(Required)

Age(Required)

Place of Birth(Required)

List Valuables(Required)

Sex(Required)

Relationship(Required)

Representative Name(Required)

Removal Valuable

Yes

No

Implant Device

Yes

No

Radioactive Implants

Yes

No

Instruction

Representative Signature(Required)

Date Digned(Required)

Representatibe Name(Required)

Representative Phone(Required)

Representative Address(Required)

Witness Name(Required)

Initials(Required)

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Email