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Click ‘Get Form’ to open it in the editor.
Begin with Section 1: Deceased individual. Fill in the CRM#, last name, first name, middle initial, date of birth (if known), and date of death.
Proceed to Section 2: Requestor information. Enter your last name, first name, middle initial, address, city, state, phone number, email, ZIP code, and your relationship to the decedent by selecting one of the options provided.
In Section 3: Method for cremains to be provided, choose how you would like the cremains delivered. You can select either 'Ship to – same address above' or provide an alternative address by filling in the required fields.
Finally, certify that the information is accurate by printing your name and providing your signature along with the date.
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