Authorization for Nancy Chambers | Yellow Rose Cremation

Authorization - Nancy Chambers

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:

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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

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Timestamp

Audit

March 13, 2024 10:35 am CST

Authorization - Nancy Chambers Uploaded by YellowRose Funeral Home - obitsmd@npwelch.com IP 96.61.170.10