Interment Authorization Form
Interment Authorization Form
Please fill out this form completely to authorize the interment process as outlined below.
Deceased Information
Name
Date of Birth
Date of Death
Address
Authorized Representative Information
Name
Relationship to Deceased
Address
Phone number
Interment Details
Cemetery Name
Plot/Grave Number
Date and Time of Interment
Authorization
I confirm that I have the legal authority to authorize the interment of the deceased mentioned above. I understand and agree to the terms of the interment process.
Name:
Date:
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