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    Funeral Papers

    Uploaded by

    Pratik Kinjalaskar
    The document is an order for the release of a deceased person's body from the Haqiqat Nagar Mayor Coroner Department. It provides instructions for releasing the body to either a next of kin or non-relative representative and their chosen mortuary or disposition service. The signing parties take responsibility for the accuracy of the information provided and costs associated with the deceased person's funeral services.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Funeral Papers

    Uploaded by

    Pratik Kinjalaskar
    42 views2 pages
    The document is an order for the release of a deceased person's body from the Haqiqat Nagar Mayor Coroner Department. It provides instructions for releasing the body to either a next of kin or non-relative representative and their chosen mortuary or disposition service. The signing parties take responsibility for the accuracy of the information provided and costs associated with the deceased person's funeral services.

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    The document is an order for the release of a deceased person's body from the Haqiqat Nagar Mayor Coroner Department. It provides instructions for releasing the body to either a next of kin or non-relative representative and their chosen mortuary or disposition service. The signing parties take responsibility for the accuracy of the information provided and costs associated with the deceased person's funeral services.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    42 views2 pages

    Funeral Papers

    Uploaded by

    Pratik Kinjalaskar
    The document is an order for the release of a deceased person's body from the Haqiqat Nagar Mayor Coroner Department. It provides instructions for releasing the body to either a next of kin or non-relative representative and their chosen mortuary or disposition service. The signing parties take responsibility for the accuracy of the information provided and costs associated with the deceased person's funeral services.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Haqiqat Nagar Mayor Coroner Department

    CORONOR DIVISION
    ORDER FOR RELEASE

    Order for the release of the body of :

    Name …………………………………………………………………………………… Case No…………………………………………………….


    AKA …………………………………………………………………………………………………………………………………………………………..
    “Warning : The person signing this Order For Release is liable for all damages caused by any untruthful
    statements contained in this document (Health and Safety Code Secction 7110). It is also a criminal offense
    to knowingly file a false statement with a government agency (Penal Code Section 115 and 470)”.
    NEXT OF KIN
    I certify that, pursuant to Section 7100, Health and Safety Code and 110065 of the Government Code of
    the state of Delhi. It is my legal right to select any funeral director or disposition service. Therefore, upon
    competition of your investigation of the death of the deceased, please release the body and the personal
    property of the above deceased to the custody of.
    Mortuary ………………………………………………………………………………………………………………………………………………………
    Mortuary Address ……………………………………………………… Mortuary Telephone ………………………………………………
    Name of Next of KIN ………………………………………………….. Relationship ……………………………………………………………
    Signed ……………………………………………………………
    Address ……………………………………………………………………… City ………………………….. State …………..………………………
    Telephone ……………………………………………………..
    NONRELATIVE
    Reason for handling if not Next of KIN ………………………………………………………………………………………………………….
    ………………………………………………………………………………………………………………………………………………………………………
    I, ………………………………………………………………………………………………………………………………………………., bearing no
    relationship to the above-named deceased, having executed the above authorization do hereby assume
    full responsibilities for the cost of all funeral services in connection therewith of the above-named funeral
    director.
    Witness ……………………………………………………………………… Signed …………………………………………………………………
    Address ……………………………………………………………………… Address ……………………………………………………………….
    City ……………………………………………………………………………. City ………………………………………………………………………
    Telephone …………………………………………………………………. Telephone ……………………………………………………………
    FUNERAL DIRECTOR DISPOSITION SERVICE
    Acting as a representative of the firm of ……………………………………………………………………………………………………….
    ………………………………………………………………………………………………………………………………………………………………………
    I state that I am entitled to custody of the remains of the above-named deceased.

    I have examined Toe Tag #............................ which bears the name of …………………………………………………………
    Received by ……………………………………………………………… of ……………………………………………………………………………..
    Signed ………………………………………… Releasing Supervisor ………………………………………………………………………………
    Released by …………………………………………………………………………. Date ………………………… Time ………………………….

    Virendar Nagar, Block B, West Haqiqat Nagar, Burari, Delhi, 110084


    RELEASE HOURS : MONDAY – FRIDAY, 0800 – 1700 HOURS
    RELEASING OFFICER FAX # (909) 387 – 2989 MAKE COPY FOR FUTURE USE

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