Orange County Cremation Sr.
2230 W. Chapman Ave. Suite 219, Orange, California 92868

Phone: 714-667-7991
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Death Certificate Information

Date of Birth

Family Information For Death Certificate

Additional information about the deceased

School Information
Military
Family Information
Spouse/SRDP
Father
Mother

Authorized Informant

Person authorized to make the arrangements   ?

Your plans for the cremated remains   ?

Name and Address of person(s) who will keep the cremated remains at their residence, or county and state of ocean water if scatter at sea:



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* Urns do not come inscribed or engraved. Personalization is responsibility of client.