Pre-Interment Authorization Form

Please fill out and submit the Pre-Interment Authorization form below, prior to your appointment with Chilliwack Cemeteries.

Next of Kin or Authorized Signer

Please enter the next of kin's contact information. (Next of kin refers to a person's closest living blood relative).

Next of Kin's Contact Information

First Name (Next of Kin) *

Last Name (Next of Kin) *

Email Address *

Phone Number

Relationship to the Deceased

Next of Kin's Address

Street Address

City

Province/State

Country

Authorized Signer (if different than next of kin)

Please enter the authorized signer's contact info if they are different from the next of kin.

Signer's Contact Information

First Name (Signer)

Last Name (Signer)

Email Address

Phone Number

Relationship to the Deceased

Signer's Address

Street Address

City

Province/State

Country

The Deceased

Please enter the deceased's full legal name, and information about their place of birth and death.

Legal Name & Marital Status

First Name

Middle Name(s)

Last Name

Marital Status

Birth

Date of Birth

Place of Birth

City

Province/State

Country

Death

Date of Death

Place of Death

City

Province/State

Country

Preferred Date and Time of Service

Please include your preferred date and time that you wish to hold the service.

Preferred Date of Service

Preferred Time of Service

Thank you for completing the pre-interment authorization form. An advisor will be in contact with you to move forward with the next steps.

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We’re Here For You

You’re not alone during this difficult time.

Our experienced and compassionate advisors can help you plan ahead and help with the next steps after the death of a loved one.

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