Authorization for Removal & Embalming of Remains

I hereby designate Bi-State Cremation & Funeral Service to take charge of the Funeral Arrangements for the aforementioned deceased and I authorize the release and removal of the remains to Bi-State Cremation and Funeral Service. I authorize Bi-State Cremation and Funeral Service to embalm if requested or required.

I represent that I am the next of kin, or am acting as an authorized agent to make disposition arrangements.