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This form gives permission to transfer the deceased from the place of death to our facility.

Release and Financial Responsibility

This form gives permission to transfer the deceased from the place of death to our facility.

  • Electronic Signature:

    (In accordance with RSA 294-D New Hampshire Digital Signature Act)
  • I, the undersigned, hereby authorize and give permission to Phaneuf Funeral Homes and Crematorium or their designated agent to transfer the deceased from the place of death to their facility. I further authorize that I have the legal authority to make this decision and accept full financial responsibility for paying for the burial or cremation.
  • This field is for validation purposes and should be left unchanged.