Florida Family Cremations

Proudly Serving the Tri-County Area​

Pinellas: (727) 223-5911
Hillsborough: (813) 355-9223
Spring Hill: (352) 329-2150

Statement of Goods and Services

"*" indicates required fields

MM slash DD slash YYYY
MM slash DD slash YYYY
DIRECT CREMATION SERVICE
ADDITIONAL SERVICES AND MERCHANDISE

Call for assistance with this (727) 223-5911

  • Certified Copies of Death Certificate…….With cause of death ($10 ea):
  • Certified Copies of Death Certificate…….Without cause of death ($10 ea):
  • Urn
  • TOTAL DUE (at time of family conference/meeting)

    • ACKNOWLEDGEMENT AND AGREEMENT: I hereby acknowledge that I have the legal right to arrange the final disposition for the deceased and I authorize this establishment to perform the direct cremation services and other services and merchandise specified on this statement. By my signature below, I acknowledge that I have received, on this date, the General Price List and copy of this statement.

    TERMS OF PAYMENT: I agree to pay and/or guarantee payment of the charges listed on this statement. In the event of default of payment, I agree to pay reasonable attorney’s fees and court costs. I agree that the liability is being personally assumed by me and is in addition to the liability imposed by law upon the estate, and this agreement does not constitute a release of liability. By my signature below, acknowledgment and agreement of the above are hereby made. A sum equivalent to 2.65% of the total payment will be added to the total amount to any payment made by credit or debit card to offset the service fee charged by the credit card company for such services.

    MM slash DD slash YYYY
    Address*
    State*

    ACCEPTANCE: This establishment agrees to provide all services and merchandise specified on this statement.

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    MM slash DD slash YYYY
    Hidden

    Statement of Goods and Services

    "*" indicates required fields

    MM slash DD slash YYYY
    MM slash DD slash YYYY
    DIRECT CREMATION SERVICE
    ADDITIONAL SERVICES AND MERCHANDISE

    Call for assistance with this (727) 223-5911

  • Certified Copies of Death Certificate…….With cause of death ($10 ea):
  • Certified Copies of Death Certificate…….Without cause of death ($10 ea):
  • Urn
  • TOTAL DUE (at time of family conference/meeting)

    • ACKNOWLEDGEMENT AND AGREEMENT: I hereby acknowledge that I have the legal right to arrange the final disposition for the deceased and I authorize this establishment to perform the direct cremation services and other services and merchandise specified on this statement. By my signature below, I acknowledge that I have received, on this date, the General Price List and copy of this statement.

    TERMS OF PAYMENT: I agree to pay and/or guarantee payment of the charges listed on this statement. In the event of default of payment, I agree to pay reasonable attorney’s fees and court costs. I agree that the liability is being personally assumed by me and is in addition to the liability imposed by law upon the estate, and this agreement does not constitute a release of liability. By my signature below, acknowledgment and agreement of the above are hereby made. A sum equivalent to 2.65% of the total payment will be added to the total amount to any payment made by credit or debit card to offset the service fee charged by the credit card company for such services.

    MM slash DD slash YYYY
    Address*
    State*

    ACCEPTANCE: This establishment agrees to provide all services and merchandise specified on this statement.

    Hidden
    Hidden
    MM slash DD slash YYYY
    Hidden