AUTHORIZATION

Wright and Young Funeral Home, Inc.15332N.W. 7m Avenue Miami, Florida 33169

Telephone: 305-688-2030 Fax: 305-688-2293 Website:www.WrightandYoungFH.com Email: wyPrograms@gmail.com
AUTHORIZATION
I hereby 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 embalming. I represent that I am the next of kin, or am acting as an authorized agent for the next of kin.
Signed

Clear
Relationship
Co-Signed

Clear
Relationship
WITNESS
DATE

Month Day Year
Date
FOR VERBAL (TELEPHONE) AUTHORIZATION:
Authorization from
Relationship
Date

Month Day Year
Date
Time
Received by
Should be Empty: