At-Need Authorization

Wright Funeral & Cremation Services, Inc.
| 725 Merchant Street
| Coatesville, PA 19320
| Tel: 610-384-0341
| Fax: 610-383-7523

We are very sorry for your loss and stand ready to assist you in your time of need. If you have not already contacted us, please call us at 610-384-0341.

At Need Authorization Form

Information about the deceased

Deceased Person's Name (First Middle & Last Name)

Deceased Person's Address

Street

City

State/Province

ZIP/Postcode

I hereby designate Wright Funeral Cremation Services Inc to assist in the necessary arrangements for the above named deceased person and I authorize the release and removal of the remains to the same establishment.

I authorize Wright Funeral & Cremation Services, Inc. to embalm.

I represent that I am the next of kin or am acting as an authorized agent for the next of kin.

Name of authorizing person

Relationship to the deceased person

Today's Date

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