This authorization form is to comply with the cremation requirements of Minnesota Statutes §149A.95, subd. 4. This form grants permission to Monarch Crematory Funeral Establishment to cremate a dead human body. The person(s) signing this document declare(s) authority to control the final disposition of the deceased person named below in accordance with Minnesota Statutes §149A.80.
The person(s) signing this form below make(s) the following statements and/or acknowledge(s) being advised of the following:
- I request and authorize Monarch Crematory Funeral Establishment, located in Bloomington, Minnesota, a sub-contractor of ecremationmn.com, to cremate the human remains of
who died on
and was born on
in accordance with all applicable laws of the State of Minnesota.
- I have legal control to authorize the final disposition and cremation of the deceased person named above.
- To the best of my knowledge, I attest that the body of the deceased named above does not contain an implanted mechanical or radioactive device, such as a heart pacemaker, that may create a hazard when placed in the cremation chamber. If a device is implanted, I authorize the device to be removed per Minnesota Statute §149A.95, subd. 7.
- I authorize Monarch Crematory Funeral Establishment to remove the body from the container in which it was delivered, if that container is not appropriate for cremation, and to place the body in an appropriate cremation container. The crematory named above may dispose of the original container in a lawful manner as they see fit.
- I understand that under Minnesota Statute §149A.95 subd. 5, Monarch Crematory Funeral Establishment may reasonably rely upon this authorization to cremate and that I shall hold it harmless from civil liability or criminal prosecution for any lawful actions performed by the above-named crematory.
- I authorize Monarch Crematory Funeral Establishment to open the cremation chamber and reposition the body to facilitate a thorough cremation and to remove from the cremation chamber and separate from the cremated remains, any noncombustible materials or items. The crematory may dispose of any noncombustible materials or items in any lawful manner as they see fit, unless specific instructions are attached to this form.
- I acknowledge that the cremated remains will be mechanically reduced to a granulated appearance and placed in an appropriate container. I authorize Monarch Crematory Funeral Establishment to place any cremated remains that a selected urn or container will not accommodate into a temporary container to be disposed of in the same manner as the original container as noted below in (8).
- I acknowledge that, even with the exercise of reasonable care, it is not possible to recover all particles of the cremated remains and that some particles may inadvertently become commingled with disintegrated chamber material and particles of other cremated remains that remain in the cremation chamber or other mechanical devices used to process the cremated remains.
- I direct Monarch Crematory Funeral Establishment to release the cremated remains in the following manner: Return to the funeral home in a plastic container.
