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REGISTER YOUR CREMATION WISHES (it’s easy!)

you can register by E-Mail with form below, or you can request a registration form by mail

This Cremation Registration Form is a way of taking care of your family. Protect them from facing confusing and expensive decisions at a time of death:

When you register your wishes, we will send you the following:

• An Identification Card for your wallet—with our 24 hour emergency number.

• Notification Cards—for your family and friends to let them know your wishes

• A legal document, ready for your signature, with a postage paid return envelope. This document will validate your cremation decision under the laws of Colorado
 
Please note: Family Members are required to sign permission to cremate after the death occurs, which causes problems for families, especially when living outside Colorado.

This Cremation Registration And Declaration Form is valid under the laws of Colorado and gives you the right to legally sign for your own cremation. Simply fill the form below out, sign (fill in your name) where indicated and submit the form by pushing the "Submit" button at the end of this page.
You may also print this form and submit it by mail to the address stated on the form or bring it to any of our offices (click here for a list of our locations). If you have any questions, please call us at 303-234-0200.



CREMATION REGISTRATION AND DECLARATION FORM

for:
(Print Name)

This form is to advise family and friends of my decision to choose cremation for my final disposition. Once this form is filled out correctly, signed and witnessed, it is valid under the laws of Colorado. At my death, this form will be given to my family.

I, , being of sound mind, state that, after my death, I want my family and all others concerned to follow my wishes as stated in this Cremation Declaration Form. This form is meant to replace any information in regards to my final disposition that went before today, (today's date).

The following instructions are what I want done
after my death in regards to my cremation decision:

This is what I want done with my ashes:
(initial)

This is the person (or persons) with whom I have made my wishes known and whom I have entrusted with my cremation decisions:


(Name)
(Relationship)
(Telephone Number)

(Name)
(Relationship)
(Telephone Number)

Check one of the 2 items below:

I do want a memorial service I do not want a memorial service

Check one of the 2 items below:

I do wish to have my body viewed before cremation I do not wish to have my body viewed before cremation

If you wish any of the above, please list details, such as memorial packages, urns, obituaries, churches, etc.

Again, I wish to declare that I want cremation as my final disposition and to follow all instructions on this page.


(Your Name)
(Date)

Statement of Witnesses
(2 are necessary) I, the witness, state that the person who signed the "Cremation Registration and Declaration" form is known to me and has signed this form in my presence. He/she appears to be of sound mind and not under duress, fraud or undue influence


(Name of Witness #1)
(Address)
(Telephone Number)

(Name of Witness #2)
(Address)
(Telephone Number)

VITAL STATISTICS

(The following information is necessary for the death certificate. This information is kept strictly confidential)


Address
State
Zip Code

Telephone Number
Date of Birth
Place of Birth
Social Security Number

Check one of the following:

Married Never Married Divorced Widowed


Name of Spouse
Wife's Maiden Name

Occupation (before retirement)
Years of Education

Father's Name
Mother's full maiden
Check this box if you would like information on pre-payment plans. (Optional)


This "Cremation Registration and Declaration" Form will be kept on file with All-States Cremation. For any changes call 303-234-0200