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Resources

Home

What's Included

How it Works

FAQS

Contact

Arrange Now

Application for Cremation

Full name of applicant

First Name required

Last Name required

Address

Country

Address Line 1 required

Address Line 2 (optional)

City required

Postcode required

Occupation (optional)

Application to crematorium

Apply to The Te Rapa Crematorium, Hamilton to undertake the Cremation of the body

Full Name of Deceased

First Name required

Last Name required

Last known Address required

Country

Address Line 1 required

Address Line 2 (optional)

City required

Postcode required

Occupation (optional)

Age required

Sex required

Relationship Status required

Applicant's relationship to deceased

Are you an executor of the deceased? required

Yes No

Are you a relative of the deceased? required

Yes No

If you are a relative: State the relationship (optional)

If you are not a relative or executor: Why is this application being made by you? (optional)

Have all the near relatives of the deceased been informed of the proposed cremation? required

Yes No

If the application is not made by the executor, is there an executor of the deceased? required

Yes No

To the best of your knowledge, has any near relative or executor expressed any objection to the proposed cremation? required

Yes No

Date and place of death

What, to the best of your knowledge, was the date and hour of the death of the deceased?

Date required

Time required

in New Zealand Time

Where did the Deceased die? required

Country

Address Line 1 required

Address Line 2 (optional)

City required

Postcode required

Was the address: own address, lodging, hotel, hospital or nursing home? (optional)

Cause of death

(Tick any that apply) Do you know or have any reason to suspect that the death was due, directly or indirectly to:

Violence Poison Privation or neglect Illegal operation

Do you know any reason whatsoever for supporting that an examination of the body of the deceased may be desirable? required

Yes No

Do you know or have any reason to suspect that the body of the deceased contains a cardiac pacemaker or other biomechanical aid? required

Yes No

Medical attendant details

Name of the ordinary medical attendant of the deceased

First Name required

Last Name required

Address of the ordinary medical attendant required

Country

Address Line 1 required

Address Line 2 (optional)

City required

Postcode required

Give the names and addresses of all medical practitioners who attended the deceased during his/her last illness required

Who were the persons (if any) present at the time of death? (optional)

Religious denomination

Was the deceased a member of a religious denomination whose tenets require the burning of the body to be carried out as a religious rite elsewhere than in an approved crematorium? required

Yes No

If yes, give the name by which that religious denomination is known (optional)

Declaration and signature

I have been advised of the list of items prohibited for cremation and agree to make sure none of these items are included in the casket, or they can be easily removed prior to cremation. I HEREBY CERTIFY, with a view to procuring the cremation of the body of the above-named deceased, that all the particulars stated above are true, and that to the best of my knowledge and belief no material particular has been omitted.

By ticking the checkbox I recognise this as my authorisation as if it was my signature required

Date Signed required

Witness details

Witness name

First Name required

Last Name required

Witness Signature: By ticking the checkbox I recognise this as my authorisation as if it was my signature required

Witness Occupation (optional)

Witness Address required

Country

Address Line 1 required

Address Line 2 (optional)

City required

Postcode required

Authorisation of Funeral Director: I have authorised the following Funeral Director to act on my behalf in relation to this cremation (optional)

Your information is handled with care and strict confidentiality by Simply Cremations. Need help? Call us on 0800 920 222.

* Note: The term "near relative" as used in this form means (a) the spouse, civil union partner, or de facto partner of the deceased, but only if the spouse, civil union partner, or de facto partner was living together with the deceased immediately before his/her death; and (b) a parent of the deceased; (c) any child of the deceased who is aged 16 years or over; and (d) any other relative of the deceased who usually resided with him/her.

Thank you

Your application has been received. A member of our team will be in touch shortly.
For immediate assistance call 0800 920 222.

Simply Cremations

Hamilton · Tauranga · Te Awamutu · Cambridge · Waihi

info@simplycremations.co.nz
0800 200 635

Application for Cremation

Thank you

Simply Cremations

Available

24 hours a day
7 Days a week
New Zealand - North Island

Application for Cremation

Thank you

Simply Cremations

Available

24 hours a day7 Days a weekNew Zealand - North Island

24 hours a day
7 Days a week
New Zealand - North Island