Other Forms:

Degrees of Kinship
Right to Control Dispostion
  1. Decedent
  2. Agent under POA for Health Care
  3. Spouse or Domestic Partner (SRDP)
  4. Adult Children
  5. Parents
  6. Siblings
  7. Grandchildren, Grandparents
  8. Great-Grandchildren, Nephews, Nieces, Uncles, Aunts, Great-Grandparents
  9. Etc.

If there is more than one Next of Kin at the same Degree of Kinship, a majority is required.

Next of Kin

Name Address City State Zip Phone Email


Name Address City State Zip Phone Email


Preneed Disclosure (at time of death):

Embalming Authorization:

Irvington Memorial Crematory (for cremation only):
In the event the cremated remains do not all fit in the container I have chosen, I direct the Crematory to:
Special Instructions:

Obituary Release:
Add obituary to our website.
Add photograph to obituary.
Copy newspaper obituary (if purchased). Include link to Online Memorial.
Include link to Tribute Video (if purchased).

Click the Submit button to email the form data to us.


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Beddingfield Funeral Service
4323 Moorpark Ave Ste C
San Jose CA 95129
Tel: 408-777-8100