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Authorization - Valerie Rose Donnelly (3)

Name of decedent:

Name of person identifying decedent:

Relation to decedent:

I agree to identify the decedent through online identification. I acknowledge that I am the
next of kin, have viewed the photo online, and identified the photo as the decedent listed
above.

Signature of person identifying decedent:

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Your legal name

Your email address

Please Confirm full name and signature.

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

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Timestamp

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November 8, 2024 9:27 am CST

Authorization - Valerie Rose Donnelly (3) Uploaded by Anderson Simple Cremations - info@andersonsimplecremations.net IP 12.55.175.202