Please Provide Your Confirmation Number.

STATEMENT OF AUTHORITY TO CONTROL DISPOSITION OF REMAINS
(Provided by the funeral director) - MUST NOTARIZE FORM

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

(Print this form and Sign at the notary. Then Scan and email to:nycfuneraldirector@gmail.comor 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 )
Prices are subject to change without notice

I, (Legal Next of Kin), , hereby affirm that in accordance with New York State Public Health Law § 4201, I am the person with the right and authority and priority to control the disposition of the remains of the Decedent .

Pursuant to Public Health Law § 4201 2. (a): The following persons in descending priority shall have the right to control the disposition of the remains of such decedent: (Must check one, relation to Decedent)

I hereby state that I am (Check one):

I hereby state that I am not aware of any contest or dispute regarding the disposition of the Decedent's remains.

I hereby affirm the foregoing to be true and correct under penalties of perjury.

  • Sworn to before me this

    day of ,202

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