Harris County (HCIFS) Authorization of Next of Kin Release Form
In accordance with state law, the Harris County Institute of Forensic Sciences (HCIFS) will perform an inquest or autopsy to determine the cause and manner of death of the decedent. If an autopsy is performed, certain organs and tissue are removed for necessary examination and testing. Upon completion of examination and testing, any organs and tissue kept by the HCIFS will be disposed of in accordance with health and safety guidelines.
Case number: Name of Decedent:
I, , bearing the relationship of attest that I am the legal next of kin, as defined above by Texas Health & Safety Code §711.002 and that there is no other person with a priority of right to control the disposition of the decedent’s remains listed before me.
I hereby authorize the HCIFS to release the decedent named above and any personal effects in the possession of the HCIFS to Funeral Home / Transport Service or its agent upon presentation of this completed document and government-issued photo identification. The transport agent agrees to follow all requirements of Texas Occupations Code §651.401
THIS IS A GOVERNMENTAL RECORD AS DEFINED BY TEXAS PENAL CODE SECTION 37.10. BY SIGNING THIS DOCUMENT, I REPRESENT THAT I AM THE NEXT OF KIN AND THERE IS NO OTHER PERSON WITH A PRIORITY OF RIGHT TO CONTROL THE DISPOSITION OF THE REMAINS LISTED BEFORE ME. I AGREE TO INDEMNIFY AND HOLD HARMLESS HARRIS COUNTY, ITS OFFICERS, AGENTS AND EMPLOYEES FROM ALL CLAIMS OF ANY CHARACTER, TYPE OR DESCRIPTION, INCLUDING BUT NOT LIMITED TO NEGLIGENCE, GROSS NEGLIGENCE, AND/OR WILLFUL AND MALICIOUS CONDUCT AND RELEASE ANY PERSON WHO ACTS IN RELIANCE ON THIS DOCUMENT FROM ANY LIABILITY, AND ACKNOWLEDGE THAT I AM LIABLE FOR ALL DAMAGES THAT RESULT, DIRECTLY OR INDIRECTLY, FROM MY REPRESENTATIONS AND SIGNATURE. ANY DISPUTE AMONG THE DECEDENT’S NEXT OF KIN CONCERNING THE RIGHT TO CONTROL THE DISPOSITION OF DECEDENT’S REMAINS MUST BE RESOLVED AMONG THOSE PERSONS BY A COURT OF COMPETENT JURISDICTION. THIS INDEMNITY AND RELEASE IS BINDING ON ME, MY FAMILY, ESTATE, HEIRS AND ASSIGNS.
Next of Kin Signature: Please sign at the bottom part of the document. Date Signed: November 30, 2020 Next of Kin Contact Number:
Next of Kin Address:
Witness Signature: Please sign at the bottom part of the document. Date Signed: November 30, 2020 Witness Contact Number:
Witness Address: Revised 01/2020
1861 Old Spanish Trail, Houston, Texas 77054 | (832) 927-5000 | ifs.harriscountytx.gov
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Your legal name
Your email address
Signed by Brandon Lee
Signed On: November 18, 2020
If you have questions about the contents of this document, you can email the document owner.
Document Name: Harris County (HCIFS) Authorization of Next of Kin Release Form
Agree & Sign