Certificate of Identification

Section A

Full name*

Residential Address*

Full name of deceased*

Certify

As the Funeral Director engaged to arrange the funeral of the above listed deceased, you hereby certify the following.

The body of the deceased has not been identified because*

In my opinion, the body is not in a fit state to be viewed
After reasonable effort I have been unable to have and identification made

The body is in a coffin bearing the name plate / inscription marked*

Full name(s)*

Date*

Endorsed by applicant for funeral*

Date*

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