Authorization for Removal of Decedent Form Authorization for Removal of Decedent Form Authorization for Removal of Decedent EmailThis field is for validation purposes and should be left unchanged.The undersigned hereby authorize the above named funeral home to take charge of the funeral of: Name of the Deceased(Required)And I authorize the release and removal of the remains to the said funeral home. I represent that I am the next of kin or am acting as a duty authorized agent for the next of kin.SignedName(Required)Signature(Required)Relationship(Required)Phone #(Required)Email(Required) Co-SignedNameSignatureRelationshipPhone #Witness Name(Required)Signature(Required)Date(Required) Embalming AuthorizedFor Verbal (Telephone) AuthorizationAuthorization from:Recieved by:RelationshipPhone #Date Time Hours : Minutes AM PM AM/PM If further information or clarification is required please call 215-622-9770
