Funeral director notification of appointment form

Coroners crest

By completing this form I confirm that I have been formally appointed by the person named below to carry out the funeral arrangements.

About the deceased

Name

Date of birth (DD/MM/YYYY)

Date of death (DD/MM/YYYY)

Date of funeral (DD/MM/YYYY) (if known)

Name of funeral director

Address of funeral director

Telephone number

Email address

Date of instruction (DD/MM/YYYY)

Name of the person who has appointed the funeral director

Please provide any additional relevant information or special instructions: