27-33 Bedford Street, Concord, Massachusetts 01742
(978) 369-2030

AUTHORIZATION FOR CREMATION

I here by designate the above-named funeral establishment to take charge of funeral arrangements for:

and I authorize the release and removal of the remains to said funeral establishment for the purpose of cremation.

I represent that I am the next of kin, or am acting as an authorized agent for the next of kin.