1Choose Your Service2Location3DC4Loved One5Your Details6Travel Protection7Delivery Options8Choose Urns9Release10Completion Simply choose your service and let us know who it’s for.Service Packages Immediate Cremation (Someone Has Passed) Pre-Planning (Make Arrangements for the Future) CSA’s all-inclusive Direct Cremation truly simplifies a very challenging process. Thousands of families trust CSA to provide care and expertise when they need it most. Direct Cremations include the following: Industry leading Online Arrangement System Cremation Simplified®24/7 Help of Licensed Funeral Director and/or Cremation SpecialistTransfer of Loved One into our CareOn-Site Holding of Loved OneObtain required authorizations and permits prior to cremationFiling of necessary paperwork for Death CertificateOn-Site Private Cremation of Loved OneAlert Social Security of Loved One’s passingFree USPS Priority Mail Express® (PME) with tracking informationNobody likes to think about Pre-Planning their cremation. We get it! That’s why at CSA, we make the process as easy as possible. Lock in our low prices today and pay over 12 months. After Pre-planning our customers say, “That wasn’t that bad.” Or “It feels good to know I took care of that.” Pre-Planning a direct cremation includes every item in the Direct Cremation Package, but with these added benefits: Industry leading Online Arrangement System Cremation Simplified® 24/7 Help of Licensed Funeral Director and/or Cremation Specialist Pre-Plan for either Near or Distant future Recording of all necessary information Optional “Reliant Travel Protection” to provide 100% Peace of Mind Pay in full or over 12 months interest free Are you planning for yourself? Yes No When are you planning for? Near-Future (within 6 months) Distant Future (over 6 months) Name of Deceased* Name of Beneficiary* Where is {:2} {:77} located?Where is now?*Adult Foster CareAssisted Living FacilityFuneral HomeHospice FacilityHospitalMedical Examiner's Office / CoronerNursing HomePrivate ResidenceOtherI'm not sureSelect county where death occured*Choose a countyBrowardDadePalm BeachBrevardCharlotteCollierDe SotaGladesHardeeHendryHighlandsHillsboroughIndian RiverLeeManateeMartinMonroeOkeechobeeOrangeOsceolaPascoPinellasPolkSarasotaSt. LucieDid/will the transfer (removal) of your loved one occur: 9am-5pm Included 5pm-9am $100 Add a Death Certificate Death certificates in Florida are issued both with cause of death and without cause of death. Average number of DC’s are 3-5 “without cause” and 1-2 “with cause. Death Certificates with cause of death may only be issued to the following individuals: decedent’s spouse or parents, decedent’s children, grandchildren or siblings, if of legal age; or to any person who provides a will, insurance policy or other document that demonstrates his or her interest in the estate of the decedent.Add a Death Certificate (With Cause) Life Insurance – Pensions – Social Security – Certain Credit Cards 012345678910Add a Death Certificate (Without Cause) Sell or transfer title of real property - Sell or transfer title of a car, boat, jet ski, motorcycle, etc. – Bank Accounts – Certain Credit Cards – Annuities – Brokerage Accounts (Stocks and Bonds) 012345678910 Tell us more about {:2} {:77}. This is important information. Don’t worry if you don’t have it all, we’ll follow up later.Referred By: What is 's full legal name?* First Middle Last Email* Date of Death* Day Month Year When did pass?Time Hours : Minutes AM PM AM/PM SSN* AgeDate of Birth* Day Month Year Sex:*Select OptionMaleFemaleArmed Forces: Yes No Birthplace* City ZIP / Postal Code Birthplace Lookup CountryAfghanistanAlandAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAscensionAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (DRC)Cook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Islas Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (North Korea)Korea (South Korea)KosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territories (Gaza Strip and West Bank)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-Leste (East Timor)TogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweCountryState / ProvinceAlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingAmerican SamoaVirgin Islands of the U.S.GuamNorthern Mariana IslandsPuerto RicoU.S. Minor Outlying IslandsStatePlace of Death Facility Name* Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Occupation Marital Status:*Select OptionNever MarriedMarriedMarried But SeparatedWidowedDivorcedSpouse: Residence* Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Decedent of Hispanic Or Haitian Origin? No - Not of Hispanic/Haitian Origin Unknown if Hispanic/Haitian Origin Yes, of Hispanic/Haitian Origin If Yes, Of Hispanic/Haitian Origin (Select One) Haitian Mexican Puerto Rican Cuban Other Hispanic (Specify Below) Other Hispanic RaceWhiteBlack or African AmericanAmerican IndianAsianNative HawaiianEducation8th grade or less9th - 12th grade, no diplomaHigh school graduate or GED completedSome college credit, but no degreeNative HawaiianAssociate degree (e.g., AA, AS)Bachelor’s degree (e.g., BA, AB, BS)Master’s degree (e.g., MA, MS, MEng, MEd, MSW, MBA)Doctorate (e.g., PhD, EdD) or Professional degree (e.g)Father's Name:* First Last Mother's Name:* First Last Almost done.Now, tell us about you.Your Name* First Last Address* Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Is Deceased your...*Select OneSpouseParentChildSiblingGrandparentPartnerFriendOtherIs Beneficiary your...*Select OneYourselfSpouseParentChildSiblingGrandparentPartnerFriendOther Travel Protection offers Peace Of Mind Shall a death occur while traveling, our Travel Protection plan lifts the burden from your loved one. One phone call is all it takes and our transport facilitators will make the arrangements, and pay the cost so your family won’t have to. Membership Benefits Include: Return of mortal remains when you’re 75 miles or more from your legal residence. Contacting a licensed funeral home near the place of death Transportation of the deceased to us Preparing of all documentation One Time Fee of $495Yes, I want to add travel protection to my arrangements Yes, I want to add travel protection to my arrangements. Delivery method of the remainsSelect one of our elegant delivery methods* USPS Priority ExpressTrust our caring professionals to properly pack for secure shipping via the US Mail. Using express mail and marked, the United States Postal Service uses extreme priority to ensure our packages get to you right away.Free Hand DeliveryWe offer US Mailing with all our packages, however care and elegance is one of our top priorities. And for this reason, our professional staff offers Hand Delivery of your loved ones ashes dirrectly to your home within the tri-country area.$150 Scatter Ashes At Sea Dignity PackageAllow us to scatter the ashes in the Gulf Stream off the coast off SE Florida. We provide you with GPS coordinates and a certificate of burial. All scatterings are done 3 miles off the coast per the EPA Regulations and we file required paperwork per US Code (40CFR229.1)$150 Scatter Ashes At Sea Captains Tribute VideoUpgrade your sea scattering service to include flowers as well as a short video showing the scattering. Our USCG certified captain will proceed to provide a beautiful ceremony with honor. Watch Example Video$995 Choose UrnsUrn Selection Sunset Scattering Urn$135.00 Eco Water Urn$145.00 Newport Urn$175.00 Newport Urn$175.00 Slate Gray Urn$135.00 Midnight Urn$175.00 The Living Urn$245.00 Mahogany Burlwood Chest$295.00 Temporary Plastic Container$0.00 Clothing ReleaseName of Deceased The undersigned legally authorized to interact with Cremation Society of America for the above named decedent, hereby request that the following items to be properly disposed of by cremation by Fred Hunter Crematory. Any clothing items including but not limited to sheets, pillows and/or blankets. I understand that these items may be soiled and the Cremation Society of America has recommended proper disposal.Signed: XLegally Authorized Next of Kin: Release FormName Of Beneficiary Name of Deceased Date of Birth DD slash MM slash YYYY AgeLocation of Deceased Address of Location Deceased Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Signed: XI undersigned hereby authorizes the release of the above named decedent to CREMATION SOCIETY OF AMERICA to care and prepare for disposition. I hereby represent that I am the nearest degree of relationship to the deceased.Date Day Month Year Relationship to Beneficiary Relationship to Beneficiary Self Relationship to Deceased Witness Signature:Print Name Please process payment to complete.Payment Options Pay in full Pay in 12 Months Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name Purchase SummaryDirection Cremation with Cremation Integrity Promise™ Price: Medical Examiners Fee: Broward County Transfer (Removal) of Loved One Death Certificate (With Cause) x 0 Death Certificate (Without Cause) x 0 Delivery Method: USPS Priority Express Sunset Scattering Urn Eco Water Urn Newport Urn Blue Newport Urn Red Slate Gray Urn Midnight Urn The Living Urn Temporary Plastic Container Mahogany Burlwood Chest Travel protection Total Equated Monthly Installment (EMI) Δ
