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RELEASE FORM - FORM MUST BE NOTARIZED
N.Y.C. Funeral + Cremation Service Inc.

(Print this form and Sign at the notary. Then Scan and email to: nycfuneraldirector@gmail.com or FAX 800-376-7401)(Please fill out all fields highlighted in yellow only!)
(As an alternative to going out to get this notary form signed, this form can now be signed online without leaving the comfort of your home. - https://www.onlinenotary.net )
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Authorization to Remove the Decedent, Authorization to Cremate the Decedent, And Authorization to Mail Cremains to Designated Person, Release of Liability

Name of the 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, to cremate the decedent, and to mail the cremains of the decedent to, whose address is . The undersigned acknowledges that cremains will be mailed directly from the crematory using the United States Postal Service. The undersigned agrees to hold The N.Y.C. Funeral + Cremation Service Inc. harmless for any damage or loss of cremains during mailing and delivery. The undersigned certifies that he/she has the right to give this authorization for mailing cremains, and that he/she further agrees to hold The N.Y.C. Funeral + Cremation Service Inc. harmless for any and all liability of said authorization. The undersigned certifies that he/she, is the closest legal next of kin of the Decedent, and the undersigned certifies that he/she, is the person legally in charge of making cremation arrangements of . The undersigned certifies that he/she is not aware of any other closer legal next of kin to the Decedent. If is knowingly misrepresenting himself/herself as the closest legal next of kin to the decedent, will be responsible for any legal costs that arise from this misrepresentation. The N.Y.C. Funeral + Cremation Service Inc. has the legal right to sue for all the damages and costs due to misrepresentation. Rosemount Memorial Park Crematorium is solely responsible for the cremation of the Decedent, the preparation of the cremains and placement of cremains in the urn, placement of metal tag in urn, preparation of urn labels, certificate of cremation, and Rosemount Memorial Park Crematorium form, and mailing of cremains by USPS with tracking and signature. Rosemount Memorial Park Crematorium is solely responsible for any errors in mispelling or labeling on metal tag, urn label, certificate of cremation, and Rosemount Memorial Park Crematorium form that are mailed with the cremains. hereby agrees to indemnify and keep harmless The N.Y.C. Funeral + Cremation Service Inc. and its representatives for and from all liability due to said authorization, cremation, disposition, preparation/placement of cremains in urn, error on metal tag, error on urn labels, certificate of cremation and Rosemount Memorial Park Crematorium form that are mailed with cremains, and mailing of cremain as stated herein.

Please Sign at both : ______________________
X and Date
Date:
X
(The legal person to Authorize Cremation)

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    below:
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