Body Release & Cremation Authorization Form
I, the undersigned, certify, warrant and represent that I have full legal right and authority to
authorize Allen & Shaw Cremations, Lic# F041565 and/or their agents to remove, take
possession of, transport and arrange for the final disposition for the remains
of:_____________________________, age_____ who died in________________County,
Florida on the______day of_____________________at_______am/pm. I, the undersigned,
certify, warrant and represent that I have full legal right and authority to authorize Allen & Shaw
Cremations to make arrangements for the cremation and that the cremains be: ( Pick up,
Scatter at Sea or Ship) If pick up, who is authorized. If ship please write address.
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The cremation shall be performed in accordance with all governing laws, rules, regulations and policies of
Allen &Shaw Cremations, the crematory, the State of Florida and the following terms and conditions.
1. The remains of the deceased must be in a combustible, leak resistant, rigid container.
2. To prevent damage to the cremation chamber, I authorize the removal of any type of implanted mechanical or radioactive
devices(such as pacemakers, etc.).
3. The deceased will be cremated using the application of intense heat and flame and that the cremains, consisting primarily
of bone fragments will be mechanically processed to an unidentifiable consistency prior to placement in an urn or other
container. I further understand and acknowledge, that 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 remaining in the cremation
chamber and/or devices used to process the
cremated remains.
4. I understand that Florida Statute, Section 497.607(2) states that in the event that the cremains remain unclaimed for a
period of 120 days, Allen & Shaw Cremations is authorized and directed to dispose of the cremains in any lawful manner it
may seem appropriate.
5. I agree to indemnify, release and hold Allen & Shaw Cremations, the crematory, their affiliates, agents, employees and
assigns,harmless from any and all loss, damages, liability or causes of action (including attorney's fees and expenses of
litigation) in connection with the cremation and disposition of the cremains of the deceased as authorized herein.
By signing below, I warrant that all representations and statements made herein are true and
correct and that I have read and understand the provisions contained in this document.
Printed Name:_________________________ Signature×_____________________________
Relationship:__________________________ Phone (include Area Code)_________________
Address:_____________________________________________________________________
City_____________________State___________________Zip Code_____________________
Allen & Shaw Cremations
13931 NW 20th Court • Opa Locka, FL 33054
Phone: 305-681-1426 or 800-681-1426 · Fax: 305-687-4064 or 800-458-8578
www.allenandshawcremations.com
