Funeral Goods & Services Agreement

# Funeral Goods & Services Agreement > **Your Rights Under the FTC Funeral Rule (16 CFR Part 453).** You have the right to choose only the funeral goods and services you want. You are not required to purchase any package. You have the right to receive an itemized price list before making any selections. Embalming is generally not required by law; check with Funeral Home or your state's laws. You have the right to use an alternative container instead of a casket for cremation. You are not required to purchase a package or items you do not want. Funeral Home is required by federal law to give you accurate price information. **Statement Date:** ___________ **Case Number:** ___________ **Funeral Home:** ___________ **Address:** ___________ **License Number:** ___________ **Funeral Director:** ___________, License Number: ___________ --- ## Part I — Identification of Deceased and Responsible Party ### Deceased **Full Legal Name:** ___________ **Date of Birth:** ___________ **Date of Death:** ___________ **Place of Death:** ___________ **Social Security Number (last 4 digits):** ___________ ### Responsible Party / Next-of-Kin Authorization **Name:** ___________ **Relationship to Deceased:** ___________ If "Other": ___________