Authorization - Tina DeLavern


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:

Leave this empty:

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Signature Certificate
Document name: Authorization - Tina DeLavern
lock iconUnique Document ID: 7ea161ee7049ec62e176d7167e0f62b78117dfbf
Timestamp Audit
December 26, 2022 4:17 pm CSTAuthorization - Tina DeLavern Uploaded by YellowRose Funeral Home - [email protected] IP 96.61.170.10