Authorization for Jane Test Doe | Northern Virginia Burial & Cremation Society

Authorization - Jane Test Doe

Name of decedent:   

Name of person identifying decedent:    

Relation to decedent:     

I agree to identify the decedent through online identification. I acknowledge that I am the
next of kin, have viewed the photo online, and identified the photo as the decedent listed
above.


Signature of person identifying decedent:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

July 25, 2024 10:42 am EST

Authorization - Jane Test Doe Uploaded by fh admin - test@fortyau.com IP 107.199.111.23