6607 Highway 1764 | Texas City, TX 77591
Full Name of Decedent*: *This name is what will appear on the death certificate
Age: Race: Sex:
Address of Decedent:
I (we), being the legal next of kin according to the priority list below, release the body to Phone # of Funeral Home: Fax # of Funeral Home: Address of Funeral Home: Signature of Next of Kin: Please sign at the bottom part of this document.
Date Signed: October 5, 2022 Witness to signature above: Date Witnessed: With this signature, I attest and affirm that I (we), am (are) the legal next of kin according to priority list below:
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Galveston County Medical Examiners Release Form
Agree & Sign