eSign Funeral Forms

The County of Galveston Medical Examiners Office 

6607 Highway 1764 | Texas City, TX 77591 

Phone: 409-935-9274 

Fax: 409-935-8305 

Authorization to Release Body 

Full Name of Decedent*:
*This name is what will appear on the death certificate 

Age:    Race:   Sex:    

Address of Decedent:

The Legal Next of Kin to the decedent according to the priority order list below: 

 

Address and phone number of Legal Next of Kin:

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 I (we), being the legal next of kin according to the priority list below, release the body to:

  Funeral Home.
Phone # of Funeral Home: Fax # of Funeral Home:
Address of Funeral Home:

Signature of Next of Kin: Please sign at the bottom part of this document. (Person handling remains) Date: November 21, 2024

Witness to signature above: (Please sign at the bottom part of this document. )  
 Date: November 21, 2024

With this signature, I attest and affirm that I (we), am (are) the legal next of kin according to priority list below: 

Priority Order of Next of Kin (Texas Health & Safety Code 711.002) 

  1. A person designated in a written instrument signed by the decedent 
     
  2. The decedent’s surviving spouse
    If you answered no;
  3. Any one of the decedent’s surviving adult children
    If you answered no;
  4. Either one of the decedent’s surviving parents
    If you answered no;
  5. Any one of the decedent’s surviving adult siblings
    If you answered no;
  6. Any adult person in the next degree of kinship in the order named by law to inherit the estate of the decedent
    (If yes, please submit the paperwork, If you answered no;
  7. Person(s) handling remains other than legal next of kin (send letter explaining situation)
     

Leave this empty:

Signature arrow sign here

Signed by Miller Josey Mortuary LLC
Signed On: May 19, 2024


Signature Certificate
Document name: Authorization to Release Form - Galveston County
lock iconUnique Document ID: b155500036ccb45d40dfdf22d155016b0594a6f5
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May 18, 2024 11:56 pm CSTAuthorization to Release Form - Galveston County Uploaded by Miller Josey Mortuary LLC - miller-josey@sbcglobal.net IP 112.204.109.9
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