Release Form

N.Y.C. Funeral + Cremation Service Inc.

800-969-6602

Release Form: Authorization to Remove the Decedent,
Cremate the Decedent , And Mail Cremains to Designated Person

(Please fill out all fields highlighted in yellow only!)

Name of Decedent
Date of Death

The undersigned hereby confirms that he/she has given authorization to allow The N.Y.C. Funeral & Cremation Service Inc. permission to remove the Decedent. The undersigned further acknowledges that he/she authorizes The N.Y.C. Funeral & Cremation Service Inc. to cremate the Decedent. The undersigned certifies that he/she will not hold The N.Y.C. Funeral & Cremation Service Inc. responsible for any personal belongings such as clothing, jewelry or any item that is with the Decedent when he/she is removed. The Decedent and all personal belongings found with/or on the Decedent will be cremated with the Decedent. The undersigned acknowledges that he/she allows The N.Y.C. Funeral & Cremation Service Inc. permission to mail the cremains of decedent, to

Name

Address

Phone

Do not schedule any type of memorial service until you have the cremains in your physical possession. The N.Y.C. Funeral & Cremation Service Inc. is not responsible for any delay in the delivery of cremains to you.

After payment is submitted for cremation, no refunds of any type on the payment made. All sales are final on cremation , mailing fees, and all services. All payment is non-refundable.

United States Post Office Disclaimer: We use the United State Postal Service (USPS) to ship urns back to families. In every case, all urns are sent via tracking number and signature required. Although this delivery method is considered a safe method of delivery, there is always a slim chance of package loss. If you are not comfortable with USPS delivery, please pick up your urn directly from the crematory. The N.Y.C. Funeral & Cremation Service Inc. is not held liable for USPS mailing. Rosemount Memorial Park is held responsible for mailing of cremains.

The undersigned certifies that he/she have the right to give this authorization and that he/she further agree to hold The N.Y.C. Funeral & Cremation Service Inc. harmless for any and all liability of said authorization.

Date:
Signature of agent:

Print Name

Relationship to Deceased

Address of Person Signing

Phone Number of Person Signing

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Signature of agent