Complete the fields below and we will prepare the necessary authorizations for you to review and sign. Step 1 of 3 33% Who is being cremated?* First Name / Last NameNext-of-Kin or Authorized Agent's Name:* First Name / Last NameNext-of-Kin or Agent's Phone*Next-of-Kin or Agent's Email* Next-of-Kin or Agent's Relationship* Spouse, parent, brother, sister, etc. 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. I agree to the additional terms & disclosures:*The following is a synopsis of our Additional Terms & Disclosures section. You will have an opportunity to read the entire text before submitting the master document. Certified death certificates can take 3 to 4 weeks to arrive in our office once the cremation is complete. Submitting obituaries to newspapers is only included with our Premium Package. YOU WILL BE RESPONSIBLE FOR PAYING THE PUBLICATION FEE. On average the cremation takes 7 to 10 business days. You will not hear from us until the cremation is complete and the death certificates have arrived unless you purchased the Priority or Premium Packages or paid for status updates separately. If we are ready to cremate and there is a delay on your part that requires us to hold off on cremation, a $50 per day storage fee will accrue. Ashes must be picked up no later than 30 days following cremation. Additional fees will apply for splitting ashes (Only available with our Priority and Premium Packages) or filling urns purchased from a 3rd party. We do not fill jewelry that was not purchased from us. A private appointment to witness the cremation or identify the deceased is available with our Priority or Premim Packages. (Additional charges will apply.) Unless we are notified in writing, everything that accompanies the deceased to the crematory will be cremated with the deceased. (Unless previously bagged and separated by the hospital or medical examiner'.s office.) Create Your Signature*Once you submit this form, your signature will be used to sign each individual document. Please review the individual documents and confirm your acceptance of the master document by submitting your signature once again at the bottom of the next page. Reset signature Signature locked. Reset to sign again Δ
