Authorization for Cremation and Disposition I, THE UNDERSIGNED, CERTIFY, WARRANT AND REPRESENT THAT I HAVE THE FULL LEGAL RIGHT AND AUTHORITY TO AUTHORIZE THE CREMATION, PROCESSING AND DISPOSITION OF THE REMAINS OF (HEREINAFTER REFERRED TO AS THE DECEASED). I authorize return of cremated remains to Community MorturaryI AUTHORIZE THE CREMATORY TO SHIP THE CREMATED REMAINS (BY U.S. MAIL IN A DESTRUCTABLE CONTAINER) TO:Shipping address Add RemoveTHE CREMATION, PROCESSING AND DISPOSITION OF THE REMAINS OF THE DECEASED AUTHORIZED HEREIN SHALL BE PERFORMED IN ACCORDANCE WITH ALLGOVERNING LAW, THE RULES REGULATIONS OF THE CREMATORY AND FUNERAL HOME, AND THE FOLLOWING TERMS AND CONDITIONS: IT IS THE POLICY OF THE CREMATORY TO REQUIRE THE REMAINS OF THE DECEASED BE PLACED IN SOME TYPE OF MINUMUM CONTAINER. IF THE DECEASED IS NOT IN A CONTAINER WHEN IT REACHES THE CREMATORY THEN A MINIMUM CONTAINER IS USED AND CHARGED TO FUNERAL HOME. WHEN A CASKET IS USED THE CREMATORY IS AUTHORIZED TO REMOVE AND DISPOSE OF ALL HANDLES, ORNAMENTS OR ANY OTHER NON-COMBUSTIBLE ITEMS ATTACHED TO THE CREMATION CONTAINER PRIOR TO CREMATION. IN THE EVENT THE REMAINS OF THE DECEASED ARE RECEIVED BY THE CREMATORY IN A CASKET OR OTHER CONTAINER MADE OF NONCOMBUSTIBLE MATERIAL, I AUTHORIZE THE DECEASED BE REMOVED PRIOR TO CREMATION AND PLACED IN A COMBUSTIBLE CONTAINER. WE FURTHER AUTHORIZE THE CREMATORY TO DISPOSE OF ANY NON-COMBUSTIBLE CASKET IN ANY LAWFUL MANNER IT DEEMS APPROPRIATE.PACEMAKERS: PACEMAKERS PACEMAKERSMAY CREATE A HAZARD WHEN PLACED IN A CREMATION CHAMBER. THE CREMATORY WILL NOT CREMATE ANY HUMAN REMAINS WHICH CONTAIN ANY TYPE OF IMPLANTED MECHANICAL OR RADIOACTIVE DEVICE. IN THE EVENT THE REMAINS OF THE DECEASED CONTAIN SUCH A DEVICE I HEREBY AUTHORIZE THE FUNERAL HOME ITS AGENTS AND EMPLOYEES TO REMOVE ANY SUCH MECHANICAL DEVICE FROM THE REMAINS OF THE DECEASED AND DISPOSE OF SUCH ITEMS AT THEIR DISCRETION. I UNDERSTAND THAT FAILURE ON MY PART TO NOTIFY FUNERAL HOME OR CREMATORY OF SUCH IMPLANT COULD RESULT IN DAMAGE TO CREMATORY WORKERS OR EQUIPMENT AND I WILL BE HELD LIABLE. DECEASED: CONTAIN ANY TYPE OF IMPLANTED MECHANICAL OR RADIOACTIVE DEVICE Does Does Not THE CREMATION CONTAINER CONTAINING THE DECEASED WILL BE PLACED IN THE CREMATION CHAMBER AND WILL BE TOTALLY AND IRREVERSIBLY DESTROYED BY PROLONGED EXPOSURE TO INTENSE HEAT AND DIRECT FLAME. I AUTHORIZE THE CREMATORY TO OPEN THE CREMATION CHAMBER DURING THE CREMATION PROCESS AND REPOSITION THE REMAINS OF THE DECEASED IN ORDER TO FACILITATE A COMPLETE AND THOROUGH CREMATION. CERTAIN ITEMS INCLUDING BUT NOT LIMITED TO BODY PROSTHESES, DENTURES, DENTAL BRIDGEWORK, DENTAL FILLINGS, JEWELRY AND OTHER PERSONAL ARTICLES ACCOMPANYING THE REMAINS OF THE DECEASED MAY BE DESTROYED DURING THE CREMATION PROCESS. I FURTHER AUTHORIZE THAT IF ANY ITEMS OTHER THAN THE CREMATED REMAINS OF THE DECEASED ARE RECOVERED FROM THE CREMATION CHAMBER THEY MAY BE SEPERATED FROM THE CREMATED REMAINS OF THE DECEASED AND DISPOSED OF BY THE CREMATORY. I HEREBY AUTHORIZE THE CREMATORY TO SEPERATE AND REMOVE FROM THE CREMATION CHAMBER ALL NONCOMBUSTIBLE MATERIALS INCLUDING BUT NOT LIMITED TO HINGES, LATCHES, NAILS, JEWELRY AND PRECIOUS METAL AND TO DISPOSE OF SUCH MATERIALS. FOLLOWING CREMATION, THE CREMATED REMAINS OF THE DECEASED CONSISTING PRIMARILY OF BONE FRAGMENTS WILL BE MECHANICALLY PULVERIZED TO AN UNIDENTIFIABLE CONCISTANCY PRIOR TO PLACEMENT IN AN URN OR OTHER CONTAINER. UNLESS AN URN OR CONTAINER SUITABLE FOR SHIPMENT IS PROVIDED THE CREMATORY WILL PLACE THE CREMATED REMAINS OF THE DECEASED IN A CONTAINER MADE OF PLASTIC AND COVERED WITH CARDBOARD WICH IS DESTRUCTIBLE AND WILL NOT BE HELD LIABLE FOR ANY DAMAGES THAT MIGHT OCCUR DURING SHIPMENT. IN THE EVENT THIS CONTAINER OR PROVIDED URN IS INSUFFICIENT TO ACCOMODATE ALL OF THE CREMATED REMAINS OF THE DECEASED ANY EXCESS CREMATED REMAINS WILL BE PLACED IN A SECONDARY CONTAINER AND RETURNED TO THE FUNERAL HOME TOGETHER WITH PRIMARY CONTAINER OR URN. I UNDERSTAND AND ACKNOWLEDGE THAT EVEN WITH THE EXERCISE OF REASONABLE CARE AND THE USE OF THE CREMATORYS BEST EFFORTS IT IS NOT POSSIBLE TO RECOVER ALL PARTICLES OF CREMATED REMAINS OF THE DECEASED AND THAT SOME PARTICLES MAY INADVERTENTLY BECOME COMINGLED WITH PARTICLES OF OTHER CREMATED REMAINS REMAINING IN THE CREMATION CHAMBER AND/OR DEVICES UTILIZED TO PROCESS THE CREMATED REMAINS. I HEREBY AUTHORIZE THE CREMATORY TO DISPOSE OF ANY SUCH RESIDUAL PARTICLES IN ANY LAWFUL MANNER IT DEEMS APPROPRIATE. I AGREE TO INDEMNIFY RELEASE AND HOLD THE CREMATORY, FUNERAL HOME THEIR AFFILIATES, AGENTS, EMPLOYEES AND ASSIGNS HARMLESS FROM ANY AND ALL LOSS, DAMAGES LIABILITY OR CAUSES OF ACTION (INCLUDING ATTORNEYS FEES AND LITIGATION EXPENSES) IN CONNECTION WITH THE CREMATION AND DISPOSITION OF THE CREMATED REMAINS OF THE DECEASED, AS AUTHORIZED HEREIN, OR MY FAILURE TO CORRECTLY IDENTFY THE REMAINS OF TH E DECEASED, DISCLOSE THE PRESENCE OF ANY IMPLANTED OR MECHANICAL RADIOACTIVE DEVICES OR TAKE POSESSION OF OR MAKE PERMENANT ARRANGEMENTS FOR THE DISPOSITION OF SUCH REMAINS. SIGNATURE OF PERSON(S) AUTHORIZING CREMATION & DISPOSITIONI WARRANT THAT ALL REPRESENTATIONS AND STATEMENTS MADE HEREIN ARE TRUE AND CORRECT AND THAT I HAVE READ AND UNDERSTAND THE PROVISIONS CONTAINED IN THIS DOCUMENTSignatureRelationship Date SignatureRelationship Date Signature lastRelationship Date Email(Required) CommentsThis field is for validation purposes and should be left unchanged.