IFA RELEASE

    International Funeral Home

    (located within Evergreen Cemetery)
    204 N. Evergreen Avenue

    Los Angeles, CA 90033

    Office: (323) 266-2300 Fax: (323) 268-6716

    AUTHORIZATION FOR RELEASE OF HUMAN REMAINS

    To Whom It May Concern*:

    I hereby authorize and designate the above name Funeral Home to take charge of the Funeral Arrangements

    Deceased Person*:

    Who Passed Away on*:

    I hereby state that I am the legal next-of-kin and that I have the legal right to control the disposition of the remains of the aforementioned Decedent.

    Signature:

    Print name*:

    Date*:

    Relationship*:

    Address*:

    City*:

    State*:

    Zip Code*:

    Contact Phone #*:

    Upload Customer ID*:

    Witness Signature:

    Date:

    Print Name:

    Phone #:

    Address:

    City:

    State:

    Zip Code: