Other Forms:

Degrees of Kinship
Right to Control Dispostion

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

Next of Kin Same as Informant

Relationship to Decedent:

Purchaser Same as NoK 1

Name	Address	City	State	Zip	Phone	Email

Relationship to Decedent:
Date of Birth:

Forms

Preneed Disclosure (at time of death):
Have preneed?
Survivor:
Embalming Authorization:
Embalm?
Irvington Memorial Crematory (for cremation only):
Infectious?
Pacemaker?
In the event the cremated remains do not all fit in the container I have chosen, I direct the Crematory to:
	A. Return the balance of the remains to me, or
	B. Place the balance of the remains in a common interment site within Irvington Memorial Cemetery.
Special Instructions:
Obituary Release:
Online Obituary?	Add obituary to our website.
Photograph?	Add photograph to obituary.
Newspaper Obit?	Copy newspaper obituary (if purchased). Include link to Online Memorial.
Tribute Video?	Include link to Tribute Video (if purchased).

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