Pacific Interment Mortuary and Crematory Service

Serving the Greater San Francisco Bay Area Since 1987

Forms

The following forms are required in order to complete disposition arrangements.   They are provided in both pdf and HTML format.   Click a form's pdf link from the list below to download the form into Acrobat Reader or whatever pdf utility your browser chooses for you.   If you have Acrobat Reader version 6.0 or greater, you can complete the forms interactively by clicking the various boxes and blanks, and typing in your answers via the keyboard.   You can't save the forms and the data, but you can print the forms after entering the data.   If you don't have Acrobat Reader or are otherwise unable to view or access the interactivity of the forms, we suggest downloading and installing the current version Acrobat Reader, here:

Fax Cover Sheet and Forms Checklist

All the forms on the checklist are required by the State of California to authorize cremation.

Authorization for Cremation and Disposition

To be signed by next of kin, this form authorizes Pacific Interment to handle the cremation & disposition of the deceased.

Authorization for Disposition With or Without Embalming

State required form that confirms next of kin's desires regarding embalming (embalming is NOT required by law).

Vital Information Form

Used to collect the information needed to complete the non-medical portion of the deceased's Death Certificate.

Hospital, Coroner, Medical Examiner Release Form

Used to obtain written permission to remove the remains from the place of death.

Declaration For Disposition

State required declaration of the next of kin regarding disposition of cremated remains.

Disclosure of Preneed Funeral Agreement

State required declaration of a pre-need funeral agreement.
Pacific Interment Mortuary & Crematory, Funeral Homes, San Francisco, CA

1 (800) 442-1810

fax (415) 431-9980

www.interment.com

pacificinterment@gmail.com

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Pacific Interment does not discriminate on the basis of race, religion, sexual orientation, or cause of death. There is no additional charge for death caused by communicable or infectious disease.