Authorization To Transmit Images Of Decedent

Authorization To Transmit Images Of Decedent
The undersigned, who represent and certify that they constitute all of the next of kin of
(insert deceased's name; the "Decedent"),

(insert deceased's name; the "Decedent"),
who died a resident of
(insert address)

(insert address)
hereby authorizes Direct Cremation of the Seacoast to transmit electronic pictures or images of the Decedent between the Direct Cremation of the Seacoast and their respective employees and agents, and to next of kin and other family members for the purposes of identification in order to comply with all legal requirements and internal procedures applicable to the Direct Cremation of the Seacoast. The undersigned further authorize the foregoing to forward such communications by electronic means without a secure connection or encryption, including, but not limited to, by electronic mail. This authorization may be executed in one or more counterparts and by different signatories in separate counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument.
Print Name & Relationship to Decedent
Signature
Print Name & Relationship to Decedent
Signature
Print Name & Relationship to Decedent
Signature
Print Name & Relationship to Decedent
Signature
Phone
This field is for validation purposes and should be left unchanged.