Have a preneed arrangement, as defined below, made by or on behalf of
If funeral establishment does have a preneed agreement, complete the following:
In compliance with Business and Professions Code Section 7745, the funeral establishment has presented to the person named below a copy of any preneed agreement which has been signed and paid for in full, or in part by, or in behalf of the deceased and in the possession of the funeral establishment.
"Preneed arrangement," "preneed agreement" or "preneed" is written instruction regarding goods or services or both goods and services for final disposition of human remains when the goods or services are not provided until the time of death, and may be either unfunded or paid for in advance of need.
Funeral Establishment's Responsibility - Business and Professions Code Section 7745 requires a funeral establishment to present to the survivor of the decedent or the responsible party a copy of any preneed agreement in its possession which has been signed and paid for in full, or in part by, or on behalf of the deceased. Business and Professions Code Section 7685.6 requires a copy of any preneed arrangements to be disclosed prior to drafting any contract for funeral goods or services. The funeral establishment may present the copy in person, by certified mail, or by facsimile transmission, as agreed upon by the person with the right to control disposition. A funeral establishment that knowingly fails to present a preneed agreement as required is liable for a civil fine equal to three times the cost of the preneed agreement, or one thousand dollars ($1,000), whichever is greater.
You may contact the Cemetery and Funeral Bureau for more information on funeral, cemetery or cremation matters or to file a complaint against a licensee:
Cemetery and Funeral Bureau
1625 North Market Blvd., Suite S-208
Sacramento, CA 95834
916-574-7870
The funeral establishment must:
Give a copy of the completed statement to the survivor or responsible party. Retain the original or a copy of the completed disclosure statement on file for not less than one (1) year after the preneed account has been audited by the Bureau or seven (7) years from the date the disclosure statement was made, whichever comes first.
Embalming is the addition to, or the replacement of, body fluids by chemical preservatives or the application of chemical preservatives for the temporary preservation of the body. I understand that embalming is not required by law.
request embalming. I understand that for storage or embalming purposes the decedent may be transported to the following location:
The undersigned hereby represents that he/she has the legal right to control disposition of the remains of the decedent
This section is to be completed by the funeral establishment if authorization to accept or decline embalming is obtained orally
The above statement regarding embalming and storage was read and/or provided to:
authorize embalming at the above named funeral establishment
This section is to be completed by the funeral establishment representative who is executing this authorization to accept or decline embalming.
I declare under penalty of perjury that the foregoing is true and correct.
in the possession of Ashes to Ashes Corporation Corp 323-644-3323,
and shall be disposed of in the following manner
Note 1: See Health & Safety Code Sections 7054, 7054.6, 7116, 7117 for legal dispositions of cremated remains.
Note 2: See Health & Safety Code Section 7100 for the list of person(s) with the legal right to control disposition of human remains.
IMPORTANT: Business and Professions Code 7685.2(b) requires Funeral Establishments to complete this form, provided by the Cemetery and Funeral Bureau, when making arrangements for cremation. Failure to complete this form may result in disciplinary action by the Bureau. This declaration does not replace the written authorization to cremate required by Health and Safety Code Sections 7110 and 7111.
A person having the right to control disposition of cremated remains may remove the remains in a durable container from the place of cremation or interment, pursuant to Section 7054.6 of the Health and Safety Code.
If the cremated remains container cannot accommodate all cremated remains of the deceased, the crematory shall provide a larger cremated remains container at no additional cost, or place the excess in a second container that cannot easily come apart from the first, pursuant to Section 8345 of the Health and Safety Code
California Department of Consumer Affairs, Cemetery and Funeral Bureau www.cfb.ca.gov
The funeral establishment, Ashes to Ashes Corporation
If the funeral establishment does have a preneed agreement, complete the following: In compliance with Business and Professions Code Section 7745, the funeral establishment has presented to the person named below a copy of any preneed agreement which has been signed and paid for in full, or in part by, or on behalf of the deceased and is in the possession of the funeral establishment
Give a copy of the completed statement to the survivor or responsible party.
Retain the original or a copy the completed disclosure statement on file for not less than one (1) year after the preneed account has been audited by the Bureau or seven (7) years from the date the disclosure statement was made, whichever comes first.
request embalming.
The undersigned hereby represents that he/she has the legal right to control disposition of the remains of the decedent.
This section is to be completed by the funeral establishment if authorization to accept or decline embalming is obtained orally.
authorize embalming at the above named funeral establishment.
in the possession of Ashes to Ashes Corporation (323) 644-3323,
Note 1: See Health & Safety Code Sections 7054, 7054.6, 7116, 7117 for legal disposition of cremated remains.
IMPORTANT: Business and Professions Code $ 7685.2(b) requires Funeral Establishments to complete this form, provided by the Cemetery and Funeral Bureau, when making arrangements for cremation. Failure to complete this form may result in disciplinary action by the Bureau. This declaration does not replace the written authorization to cremate required by Health and Safety Code Sections 7110 and 7111.
lithe cremiated remains container cannot accommodate all cremated remains of the deceased, the crematory shall provide a larger cremated remains container at no additional cost, or place the excess in a second container that cannot easily come apart from the first, pursuant to Section 8345 of the Health and Safety Code
California Department of Consumer Affairs, Cemetery and Funeral Bureau www.cib.ca.gov
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