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
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.