Declaration for Disposition of Cremated Remains | Boyd Funeral Home | Los Angeles CA funeral home and cremation

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DECLARATION FOR DISPOSITION OF CREMATED REMAINS

I/We hereby declare (my remains) or (the remains of)

Name of Person arrangements are for

in the possession of

Name of Funeral Establishment and Telephone Number

will be cremated by

Name of Crematory and Telephone Number

and shall be disposed of in the following manner (Note 1):

Manner, Location and Other Details of Disposition

Name of person(s) with the legal right to control disposition (Note 2):Print Your Name (Attach additional pages if necessary)

SignedPerson(s) with legal right to control disposition to Self, if pre-arranging

Date

SignedPerson(s) with legal right to control disposition

Date

SignedPerson(s) with legal right to control disposition

Date

SignedPerson(s) with legal right to control disposition

Date

Name of person(s) contracting for cremation services:Print Your Name

SignedPerson(s) contracting for cremation services

Date

SignedFuneral Director, Employee, or Agent for Funeral Establishment

Lic. #If a Funeral Director

Date

Note 1: See Health & Safety Code Sections 7054, 7054.6, 7116, 7117 for legal dispositions of cremated remains.

Note 2: See Health & Safety Code Section 7100 for the list of person(s) with the legal right to control disposition of human remains.

IMPORTANT: Business and Professions Code § 7685.2(b) requires Funeral Establishments to complete this form, provided by the Cemetery and Funeral Bureau, when making arrangements for cremation. Failure to complete this form may result in disciplinary action by the Bureau. This declaration does not replace the written authorization to cremate required by Health and Safety Code Sections 7110 and 7111.

NOTICE REGARDING CREMATED REMAINS

A person having the right to control disposition of cremated remains may remove the remains in a durable container from the place of cremation or interment, pursuant to Section 7054.6 of the Health and Safety Code.

If the cremated remains container cannot accommodate all cremated remains of the deceased, the crematory shall provide a larger cremated remains container at no additional cost, or place the excess in a second container that cannot easily come apart from the first, pursuant to Section 8345 of the Health and Safety Code

California Department of Consumer Affairs, Cemetery and Funeral Bureau www.cfb.ca.gov

(Rev. 10/2008)

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