The undersigned hereby represents that he/she is of the nearest degree of relationship to the above named deceased person. I am/we are legally authorized or charged with the responsibility for the proper burial and/or other disposition of the remains of the above named deceased person.

The undersigned individual(s) authorize the release of the remains of the deceased person and any personal property or effects belonging to the deceased person to the above named funeral establishment and further authorize said funeral establishment to remove the remains of the deceased person to its premises.

Except in certain special cases, embalming is not required by law. Embalming may be necessary, however, if you select certain funeral arrangements, such as a funeral with a viewing. If you do not want embalming, you usually have the right to choose an arrangement that does not require you to pay for it, such as direct cremation or immediate burial.

The undersigned individual(s) anticipates choosing a funeral arrangement that includes viewing and therefore grants permission for the above named funeral establishment to embalm the above named deceased person.