Funeral Home Request for Temporary Decedent Holding (30 Days)

Funeral Home Request for Temporary Decedent Holding (30 Days)

Richland County Coroner's Office
Name of Funeral Home
Name of Person Completing This Form

First NameLast Name
Funeral Director Name

First NameLast Name
Funeral Director Contact (Phone)
Please enter a valid phone number.Format: (000) 000-0000.
Funeral Director Contact (Email)
example@example.com
Name of Decedent

First NameLast Name
RCCO Case Number
Example: 2025-1234
BRT Number
Returned From
Returned By
Reason For Storage
Date of Storage End

MonthDayYear
Initial Holding Period: Thirty (30) Days From Form Submission Date
Other Service Providers Involved?
Additional Service Provider Contact Information
Please List the Name, Phone Number, and Email Address for Any Additional Service Providers Involved
By signing below, I certify that I am an authorized representative of the funeral home listed above and that the information provided is accurate and complete to the best of my knowledge.
Authorized Signature
For any additional questions, concerns, or follow-up regarding this request, please contact the Richland County Coroner’s Office at (803) 576-1799.
Should be Empty: