McCoy & Harrison Funeral Home

Galveston County Medical Examiners Release Form


The County of Galveston Medical Examiners Office 

6607 Highway 1764 | Texas City, TX 77591 

Phone: 409-935-9274 

Fax: 409-935-8305 

Authorization to Release Body 

Full Name of Decedent*:  
*This name is what will appear on the death certificate 

Age:    Race:  Sex:  

Address of Decedent:

The Legal Next of Kin to the decedent according to the priority order list below: 

 

 

  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: November 30, 2020

Witness to signature above:


With this signature, I attest and affirm that I (we), am (are) the legal next of kin according to priority list below: 

Priority Order of Next of Kin (Texas Health & Safety Code 711.002) 

  1. A person designated in a written instrument signed by the decedent 
  2. The decedent’s surviving spouse 
  3. Any one of the decedent’s surviving adult children 
  4. Either one of the decedent’s surviving parents 
  5. Any one of the decedent’s surviving adult siblings 
  6. Any adult person in the next degree of kinship in the order named by law to inherit the estate of the decedent

Leave this empty:

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McCoy & Harrison Funeral Home https://www.mccoyandharrison.com
Signature Certificate
Document name: Galveston County Medical Examiners Release Form
lock iconUnique Document ID: aa6e2000f5b0cd464d2326908b518cee4d1db10d
Timestamp Audit
November 15, 2020 8:56 am CSTGalveston County Medical Examiners Release Form Uploaded by Bayne Parker - bayne@baynedm.com IP 110.54.240.123