Address: 1804 Owen Ct Suite 112, Mansfield, TX, 76063, US
Telephone: (817) 546-0108

I have the full legal right and authority to authorize the cremation, and:*
- I am not aware of any person(s) with a superior right to authorize the cremation.
- All person(s) with and equal right have been contacted and will be signing this document.
- There are person(s) who have equal priority right and all reasonable efforts have been exhausted to contact said person(s). Furthermore, I believe that the person(s) would not object to the cremation. Therefore, I indemnify and hold harmless Kiser Undertakings and the crematory for any liability arising from performing the cremation without the persons(s) authorization.
Identification Prior to Cremation?*
- I choose NOT to identify the deceased
- I choose to identify the deceased in person or by photo (charges apply)
Does the person being cremated have a pacemaker?*
- Does NOT have a pacemaker
- DOES have a pacemaker
Denial of Embalming*
I refuse to give permission to embalm the the above-named deceased. (Texas State Law does not require embalming for direct cremation.)
- YES
Is the deceased at the medical examiner's office?*
- No
- Yes, Collin County Medical Examiner**
- Yes, Dallas County Medical Examiner**
- Yes, Tarrant County Medical Examiner**
**If applicable, authorization is given to remove deceased from the Medical Examiner's Office listed above to Lone Star Cremation / Kiser Undertakings place of business to care for and prepare for disposition in accordance with professional standards.