Plan Ahead

Direct Cremation Form

Please fill out the paperwork as follows

1. Complete the Vital Information form below. This is all of the information we will need to complete the Death Certificate

2. Please fill out the Cremation Authorization Form, Sign, Date, Relationship, Time, and Address

3. Have two people sign as witnesses to your signature on the Authorization form.

4. Send a copy of your STATE ISSUED I.D.

5. Email or Fax all forms. kcgoldengate@gmail.com or fax 816-569-4889

6. To make a payment. Click here
If you have any questions, or would like assistance with this form, please call (816) 368-8409

Reception Options

Reception at funeral home checkbox

Reception elsewhere checkbox

No Reception checkbox

Decedent's Name

Maiden Name (if applicable)

Date of Birth

Date of Death

Place of Death

Name of Hospital/Hospice/Nursing Home (if applicable)

Home Address

County

Years at Address

SOC SEC:

Birth City/State

Marital Status

Spouse's Name (if applicable)

Spouse's Maiden Name (if applicable)

Military

If yes, What Branch

Occupation

Hispanic Origin

Race

New Field:

Father's Name

Mother's Name

Mother's Maiden Name

Children's Name(s) and Age(s)

Cemetery Name & Location (if

Your Name

Your Phone Number

Your Address

Please fill out the Cremation Authorization Form, Sign, Date, Relationship, Time, and Address

Have two people sign as witnesses to your signature on the Authorization form.

Email or Fax all forms With State Issued I.D. to kcgoldengate@gmail.com or fax 816-569-4889