Cremation Authorization Form Instructions
**please read all instructions thoroughly before signing**
This form must be completed by the Legal Next of Kin or Legally Authorized Person. If more than one person exists with the same level of authority (ie - multiple children if there is no spouse or multiple siblings if there are no children or parents), all persons must complete a Cremation Authorization.
Please complete all of the required fields (marked with an asterisk “*”) in the below form.
All required fields must be completed before the form will enable you to submit it. To add a signature or initials click the signature or initials field to open up the form to either type your name, draw your name with the mouse (or finger if using a touchscreen device) or use an existing digital signature. There are multiple signature fields & all are required; once the first has been applied just click the subsequent signature fields to have the form copy your signature in.
Once all required fields have information a blue "Click to Sign" button will appear at the bottom of the web page. If this button does not appear that means there is info still missing, so you will need to review all fields to verify what still needs info. Once it appears, click this button to enter your email address so that Adobe Sign can send you a verification email that you will need to open and click the link to finish submitting the signed document to our representative to sign as witness & then on to the funeral director as Licensee. You must complete this email address verification step with Adobe or we will not receive the signed document, so if you don’t see this email in your inbox check your junk mail folder. If you entered your email address incorrectly you will not receive this verification email and you will need to refresh this page and try submitting the form again. When all parties have signed the form a final pdf copy will automatically be emailed to you.
Please state your preference for the disposition of the cremated remains and any special instructions related to disposition.
If requesting that the remains be mailed, please initial that you accept this additional fee.
Please specify if there is anyone else that is authorized to receive the cremated remains on your behalf.
Please contact us if you run into any issues completing & submitting this form.
**Please note - anyone completing and submitting this form is acknowledging that they are who they say the are, their relationship to the deceased is correct, they have the legal right to direct disposition (per FL Statute Chapter 497.005 (43), pertaining to legally aurhorized person) and that they know of no other parties in a higher class that has any objections to cremation as disposition.
Failure to disclose any information to the funeral home regarding legal next of kin or any familial disputes regarding disposition will be the sole responsibility of the person completing this authorization form and therefore the funeral home will not be held liable for any legal ramifications brought forth by those in the same or higher class of authority due to any dispute regarding cremation as disposition or the disposition of the cremated remains.
Please contact us if you have any questions on priority of consent regarding legal next of kin.
Also, please remember that any Power of Attorney for the deceased expires when the person dies.
FL Statute - Chapter 497.005 (43):
(43) “Legally authorized person” means, in the priority listed:
(a) The decedent, when written inter vivos authorizations and directions are provided by the decedent;
(b) The person designated by the decedent as authorized to direct disposition pursuant to Pub. L. No. 109-163, s. 564, as listed on the decedent’s United States Department of Defense Record of Emergency Data, DD Form 93, or its successor form, if the decedent died while in military service as described in 10 U.S.C. s. 1481(a)(1)-(8) in any branch of the United States Armed Forces, United States Reserve Forces, or National Guard;
(c) The surviving spouse, unless the spouse has been arrested for committing against the deceased an act of domestic violence as defined in s. 741.28 that resulted in or contributed to the death of the deceased;
(d) A son or daughter who is 18 years of age or older;
(e) A parent;
(f) A brother or sister who is 18 years of age or older;
(g) A grandchild who is 18 years of age or older;
(h) A grandparent; or
(i) Any person in the next degree of kinship.
In addition, the term may include, if no family member exists or is available, the guardian of the dead person at the time of death; the personal representative of the deceased; the attorney in fact of the dead person at the time of death; the health surrogate of the dead person at the time of death; a public health officer; the medical examiner, county commission, or administrator acting under part II of chapter 406 or other public administrator; a representative of a nursing home or other health care institution in charge of final disposition; or a friend or other person not listed in this subsection who is willing to assume the responsibility as the legally authorized person. Where there is a person in any priority class listed in this subsection, the funeral establishment shall rely upon the authorization of any one legally authorized person of that class if that person represents that she or he is not aware of any objection to the cremation of the deceased’s human remains by others in the same class of the person making the representation or of any person in a higher priority class.
