Address:
Telephone No:
Email:
Date:
Belfast City Council (BCC) is the Data Controller under the General Data Protection Regulation (GDPR) for
the personal data it gathers relating to the disposal of cremated remains. Belfast City Council is also seeking
your permission for the display of the deceased name on oral cards and electronic display screens. By
completing and signing this form you are providing your personal data and on a consensual basis and
permitting the display of the deceased name as above. Article 6 -1 (e) of GDPR additionally provides a
lawfulness for Belfast City Council to process this personal data as it is necessary for the performance of a
public task vested in Belfast City Council.
Your personal data is shared internally with sta who are involved in providing this service and when
necessary, between internal departments with the purpose of supporting an eective delivery of service.
Your personal data will not be shared or disclosed to any other organisation without your consent or unless
the law permits or places an obligation on the Belfast City Council to do so.
Your personal data is held and stored by Belfast City Council in a safe and secure manner and in compliance
with Data Protection legislation and in line with the Belfast City Council’s records retention and disposal
schedule.
If you have any queries regarding the processing of your personal data or you wish access to it, please
contact the Belfast City Council’s Bereavement Services Oce, Cecil Ward Building Belfast BT2 8BP Tel: 028
9027 0296 or email cemeteries@belfastcity.gov.uk
Once you have completed this form, please deliver it together
with forms A, B (including pacemaker/xion form), C, F, and
GRO21 form (or where the death has been reported to the
Coroner, a Coroner’s Order for Cremation) to the Medical
Referee at Bereavement Services Oce. All forms must be
submitted no later than one working day before the cremation
date and before the following times: - Monday to Thursday
12noon, Friday and Saturday 11am.
Postcode:
City of Belfast Crematorium
www.belfastcity.gov.uk
Part 2: Applicant details
Part 1: Full name of deceased
For oce use only
Cremation number:
Applicant’s instructions to Crematorium
Name:
www.belfastcity.gov.uk
www.belfastcity.gov.uk
www.belfastcity.gov.uk
Part 3: Cremated Remains
This section is used to record what will happen to the cremated remains after the cremation.
The term cremated remains means the material (other than any metal) to which human remains are
reduced by cremation, including the con and any clothing.
B.
A.
Collection by Funeral Director, who arranged the cremation.
Collection by the applicant or their representative
We will give you the cremated remains in a standard biodegradable urn. You can collect these from 12 noon the
next working day following the cremation service. You must show photographic identication when collecting
cremated remains.
After the cremation, we will hold cremated remains in the City of Belfast Crematorium for a
maximum of 16 weeks from the date of cremation. If you do not collect the cremated remains in
this time frame, we will scatter the remains in the Garden of Remembrance. We will contact you
two weeks before we intend to scatter the remains.
Part 4: Floral tributes
This area is located at the crematorium for the display of oral tributes following the cremation
service. Unfortunately the crematorium cannot accept any responsibility for any oral tributes left
in the hallway. It is recommended that oral tributes are removed from the hallway immediately
after the cremation service. Floral tributes from Monday, Tuesday and Wednesday services are
removed for disposal on the following Saturday morning. Floral tributes from Thursday, Friday and
Saturday services are removed for disposal on the following Wednesday morning.
C.
Scatter the cremated remains in the Garden of Remembrance
at the Crematorium without any relatives present.
Cremated remains are normally scattered on the lawns in the Garden of Remembrance no sooner than ve days
after the cremation service. We keep a record of the lawn where the remains are scattered, but it is not possible
to give their exact location.
Name of Funeral Director:
Name of applicant or representative:
Where applicable; address of representative:
www.belfastcity.gov.uk
www.belfastcity.gov.uk
www.belfastcity.gov.uk
Only tick if you do not consent to holding over
Only tick if you need all metal residues recovered
following cremation to be returned to you.
Part 5: Environmental Policy
B: Holding over
A: Consent for disposal of metals remaining after cremation
Please tell us how you want to dispose of metals recovered following cremation
Ferrous metals used in the construction of the con, metal used in medical implants and non-
ferrous metals which may include an unrecognisable element of precious material will be recycled
for charitable purposes through the Institute of ‘Cemetery and Crematorium Management Recycling
of Metal Following Cremation Scheme’.
If you want to dispose of the metals in any other way, please tick the box below and metals will be
returned to you with the cremated remains.
In accordance with the Code of Cremation Practice, City of Belfast Crematoriums policy allows
for the holding over of the con. We will carry out all cremations as soon as possible after the
funeral service and will only hold over in the event of health and safety, environmental and
operational reasons or mechanical failure. In circumstances were we are required to hold over
without consent, we will inform the applicant via the Funeral Director.
Soft metals (such as gold and silver) melt into tiny globules and combine with the cremated
remains. These cannot be returned separately. We recommend that precious metals in the form of
jewellery are not cremated with the deceased.
Applicant’s signature:
www.belfastcity.gov.uk
Part 6: Con Information
Identication
The Funeral Director must ensure that con has a nameplate
bearing the full name of the deceased, which shall be checked
by the Crematorium Ocial before entry into the Chapel. Any
variation from the Application for Cremation details will require
the submission of a written declaration before the cremation
can proceed.
Measurements
The external measurements of a con (including the handles
or any other adornments) shall not exceed 83 inches in length,
32 inches in width or29.5 inches in depth. Any cons that
exceed any of these individual measurements will not be
accepted for cremation.
Con Accreditation
The con must be certied suitable for cremation in
accordance with The Funeral Furnishing Manufacturers
Association (FFMA) or The Con, Casket and Shroud
Association (CCSA).
Contents of con
In order to minimise the release of pollutants to air, it is
recommended that clothing should be of natural bres such
as cotton, linen and wool, whereas shoes or any material
manufactured from PVC should not be included.
Additional items, particularly of glass or plastic must not
be placed in the con due to particulate emissions during
combustion within the cremation process. No other cremated
remains (human or pet )should be placed within the con.
Guidance for funeral directors when completing the
combined weight’ section
It is recommended that funeral directors should take steps
to obtain access to suitable weighing equipment as soon
as possible. However, in the event that suitable weighing
equipment is not available, an estimated weight should be
provided. This can be obtained provided that:, the deceased
person is in your care prior to the cremation form being sent
to the cremation authority; you are able to provide a useful
estimate based on the information available to you; and you
are able to get the information from the client (considering the
likelihood of causing upset to your client).
When providing an estimated weight, it is important that the
fact that it is an estimation rather than an accurate reection
of the combined weight is made clear. It is recommended that
the funeral director writes the words “estimated weight” next
to the estimated gure
Con Accreditation Number
Combined Weight of Con and Deceased
Length of Con
Width at Shoulder
Depth of Con
Additional Control Measures
For oce use only
CREMATION: REQUIREMENTS FOR THE COFFIN AND CONTENTS
Funeral Director (to be completed by funeral director if services are used)
Name
Address
Telephone
I have read and agree to abide by the
requirements for the con and contents
Date (DD/MM/YYYY):
Additional Control Measures
For oce use only
On arrival at The City of Belfast Crematorium, crematorium sta may decline the acceptance
of the con, if it does not comply with these requirements.
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