I hereby designate the Disposition of Cremains and acknowledge receipt of a copy of this form.
N.Y.C. Funeral & Cremation Service Inc. "Customer's Designation of Intentions"
Cremation Location: Crematory
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Printed Name and relationship to Deceased
NYC Funeral & Cremation Service Inc
Premier Funeral Cremation Service
Name of Deceased:
Manor of Disposition of Cremains:
Return to (specify person to receive cremains below)
Specify dispostion of cremains
"Cremains which shall not have been claimed within 120 DAYS from the date of cremation may be disposed of by this firm, in the following manner of disposition_______________."
Vital Statistic Form
NYC Funeral and Cremation Service Inc.
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