[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-283976-105":3,"doc-detail-283976-en":81,"detail-sidebar-cat-1-en-105":97},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","cremation-authorization-form-4","Cremation Authorization Form 4","","Authorization form for granting legal permission to a funeral home and crematory to take possession of a decedent’s remains and arrange cremation, including processing or pulverizing and final disposition. Includes confirmations of identity, legal right to authorize under G.S. 90-210.124, and disclosures about other individuals with equal or superior rights. Provides irreversible, final cremation warnings and detailed consent terms regarding removal of valuables, destruction of dental work, cremated remains handling, residual particles, urn/container requirements, and restrictions relating to implanted devices such as pacemakers.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/cremation-authorization-form-4/283976/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/cremation-authorization-form-4/283976.png","ImageObject",442,249,{"name":42,"@type":43},"Graffin","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Who can authorize the cremation process in this form?","Question",{"text":63,"@type":64},"The form requires the undersigned authorizing agent(s) to certify that they have the full legal right and authority to authorize cremation and disposition under G.S. 90-210.124.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What items may not be recoverable after cremation?",{"text":68,"@type":64},"Valuable material and items such as dental bridgework or fillings are addressed as being destroyed or not recoverable, and the agent is responsible for removing desired valuables before cremation.",{"name":70,"@type":61,"acceptedAnswer":71},"What happens if the decedent has an implanted pacemaker or other mechanical device?",{"text":72,"@type":64},"The crematory will not cremate remains containing implanted mechanical devices. The authorizing agent(s) instruct the funeral home to secure removal of such devices before cremation.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},283976,1790935890,{"code":4,"msg":82,"data":83},"success",{"doc_id":79,"user_id":84,"nickname":42,"user_avatar":85,"doc_module":22,"category_id":86,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":87,"file_id":88,"file_url":89,"file_type":90,"file_size":91,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":92,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":93,"faqs":94,"seo_title":95,"seo_description":12,"update_tm":96,"read_time":26},3573418547284,"https://eur-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d",17,"APPLICATION FOR THE AUTHORIZATION OF THE CREMATION PROCESS AND  \nINSTRUCTIONS FOR THE DISPOSITION OF  \nFirst Middle Last  \n / / /   \nDate ofBirth Date of Death Time of Death Age  \n  /   \nPlace of Death Hospice (Yes or No)  \nNOTICE: THIS IS A LEGAL DOCUMENT. IT CONTAINS IMPORTANT PROVISIONS CONCERNING CREMATION. THE CREMATION PROCESS IS IRREVERSIBLE AND FINAL. READ THIS DOCUMENT CAREFULLY BEFORE SIGNING.  \nAUTHORIZATION  \nPrinted Name of Individual Confirming Identity of Decedent:   \nSignature  \nA. The undersigned (hereinafter referred to as the “Authorizing Agent(s)”) hereby certify, warrant and represent the I/We have the full legal right and authority to authorize the cremation, to include the processing or pulverizing of the cremated remains and disposition to the remains of   (hereinafter referred to as the “Decedent”) and  \nName of Decedent  \nAgent(s) is (are) not aware of any living person who has a superior right to that of the Authorizing Agent(s) as set forth in G.S. 90- 210.124; or if there is another person who does have a superior right to that of the Authorizing Agent(s) represent that the Authorizing Agent(s) has (have) made all reasonable efforts to contact such person, has (have) been unable to do so and has (have) no reason to believe that such person would object to the cremation of the decedent.  \nInitial(s)  / /   \nB. The Authorizing Agent(s) has (have) either disclosed the location of all living persons with equal right to that of the Authorizing Agent(s), as set forth in G.S. 90-210.124, or does (do) not know the location of any living person with an equal right to that of the Authorizing Agent(s) .  \nInitials(s)  / /   \nC. I/We hereby request and authorize    \nName and address of Funeral Home  \n(hereinafter referred to as the “Funeral Home”) to take possession of and make arrangements for the cremation, processing or pulverizing and disposition of the remains of the Decedent at Jones Funeral Home Crematory, 303 Chaney Avenue, Jacksonville, NC (hereinafter referred to as the “Crematory”) in accordance and subject to (a) the terms and conditions set forth in this Authorization as outlined by the Crematory, (b) the rules and regulations of said Funeral Home and (c) any applicable state or local laws, rules and regulations.  \nInitial(s)  / /   \nI/We, the Authorizing Agent(s), do hereby certify, warrant and represent that I/we understand:  \nD. All cremations are performed individually. The cremation process begins with the placement of the cremation container into the cremation chamber where it is subject to intense heat and flame reaching temperatures of 1400 to 1800 degrees Fahrenheit. Due to the nature of the cremation process, any valuable material will not be recoverable. In the event of such valuable items in which I/we wish to retain, it is my/our responsibility to remove them or have them removed prior to the cremation process. Body prostheses, dental bridgework, or dental fillings within the remains will either be destroyed or will not be recoverable. Accordingly, the Authorizing Agent(s) represent and warrant to the Crematory that such materials have been removed from the remains or if not, that they may be removed from the remains and disposed of by the Crematory or may be destroyed by the cremation process.  \nInitial(s)  / /   \nE. Following a cooling period, the cremated remains are then removed from the cremation chamber. Cremated remains, depending on the bone structure of the decedent, will weigh approximately 4 to 8 pounds and are usually white in color, but can be other colors due to temperature variations and other factors. Even with the exercise of reasonable care and the use of the Crematory’s best efforts, it is not possible to recover all particles of the cremated remains of the Decedent; some particles may inadvertently become commingled with particles of other cremated remains remaining in the cremation chamber and/or other devices utilized to process the cremated remains. I/We hereby ","cbCaimFMaeCjQdBg","https://ap.wps.com/l/cbCaimFMaeCjQdBg","pdf",414038,"English","# Authorization\n## A. Legal right to authorize and related notice\n## B. Disclosure of persons with equal rights\n## C. Request to funeral home and crematory\n## D. Understanding of the cremation process and recoverability\n## E. Cooling, remains appearance, residual particle disposal\n## F. Urn/container requirements and capacity\n## G. Implanted pacemakers and hazardous mechanical devices\n## H. Noncombustible cremation containers","[{\"question\":\"Who can authorize the cremation process in this form?\",\"answer\":\"The form requires the undersigned authorizing agent(s) to certify that they have the full legal right and authority to authorize cremation and disposition under G.S. 90-210.124.\"},{\"question\":\"What items may not be recoverable after cremation?\",\"answer\":\"Valuable material and items such as dental bridgework or fillings are addressed as being destroyed or not recoverable, and the agent is responsible for removing desired valuables before cremation.\"},{\"question\":\"What happens if the decedent has an implanted pacemaker or other mechanical device?\",\"answer\":\"The crematory will not cremate remains containing implanted mechanical devices. The authorizing agent(s) instruct the funeral home to secure removal of such devices before cremation.\"}]","Cremation Authorization Form 4 | PDF",1789623621,{"code":4,"msg":82,"data":98},[99,104,109,114,119,124,127,132,137],{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},11,"Presentations",90,"presentations",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},12,"Resumes",80,"resumes",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},14,"Invoices",70,"invoices",{"id":115,"doc_module":22,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},15,"Posters",60,"posters",{"id":120,"doc_module":22,"doc_module_name":25,"category_name":121,"show_sort_weight":122,"slug":123},16,"Social Media",50,"social-media",{"id":86,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":125,"slug":126},40,"forms",{"id":128,"doc_module":22,"doc_module_name":25,"category_name":129,"show_sort_weight":130,"slug":131},18,"Letters",30,"letters",{"id":133,"doc_module":22,"doc_module_name":25,"category_name":134,"show_sort_weight":135,"slug":136},21,"Paper Templates",5,"papers-templates",{"id":138,"doc_module":22,"doc_module_name":25,"category_name":139,"show_sort_weight":4,"slug":140},158,"General","general-158"]