Immediate Need 

Information about the Decedent

Note: We will require social security number; however we will request that directly by phone.

Place of Death Information

Vital Statistics

If Married or Separated, please provide spouse's name below.

Parents' Information

Doctor's Information

Official Certification

This form is used to complete the death certificate, which is a legal document and filed with the State of Florida. It is therefore important to fill completely and accurately with the proper spelling of names and places. Corrections to the death certificates require 6 to 8 weeks and there are fees that apply.

Order Selections

Add a Death Certificate
Death certificates in Florida are issued both with cause of death and without cause of death.
The average number of DC’s are 3-5 “without cause” and 1-2 “with cause.
Price: $20.50 each.

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.

Death Certificates with cause: For Pensions, Social Security and Certain Credit Cards
Death Certificates without cause: For selling or transferring title of real property; sell or transfer of a car, boat, jet ski, motorcycle, etc.; Bank Accounts; Certain Credit Cards; Annuities; Brokerage Accounts (Stocks and Bonds)

Your Contact Information

Shipping Address (if different from contact information)

Body Release Authorization

Location Number - Name of Funeral Home

I, the undersigned, hereby authorize and request,

release/transfer the remains of the Decedent to:

Address of Location Deceased:

I acknowledge and agree that this release authorization permits Cremation Society of America to use the services of other funeral home/affiliates or other independent contractors in connection with the transfer of the Decedent from the place of death or Funeral Home.

I represent that I have legal authority to give this authorization. I agree to indemnify and hold harmless Cremation Society of America, its affiliates and their agents and employees from any and all liability or claim which may arise as a result of this release authorization.

Clothing and Other Items Release Authorization

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's 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 of them.

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