Authorization for scattering

(S. Florida the Atlantic Ocean)

zulickdavidm@gmail.com

I,_____________________________________________________________________, hereby grant

Permission to Anago Cremations (AC) to provide a private ocean scattering in the Atlantic Ocean of

Deceased name __________________________________________________________________. By

signing this form, I understand that the ocean scattering for the deceased will be provided with dignity, honor and in a professional manner. All ocean scatterings are provided in a timely manner by AC. Ocean scatterings are done within a 15 day period from the date which they are received (pending weather and ocean conditions). All cremated remains sent or delivered to AC must be sent via registered / receipt mail by the US Postal Service. This will give all parties a record that such delivery was properly delivered to AC, and signed for by one of our staff members. This is for your protection, as well as AC. Keep a log of the tracking and notify AC when the delivery can be expected.

Private scattering with no certificate of location…………………………………….$60.00

Private scattering with 1 location certificate…………………………….…………..$75.00

Additional Certificates are available for an additional Per………………………….$10.00

Authorized Signature__________________________________________________________

Print Name__________________________________________________________________

Address_____________________________________________________________________

Phone ( ) __________________________________________

Please send registered mail -cremated remains, appropriate payment and this signed document together to the following address:

Anago Cremations

3379 West Woolbright Road

Boynton Beach, Fl. 33436