Pick up & Burial Application Form – Sydney Islamic Funerals

DECEASED INFORMATION

Full Legal Name of Deceased

First Name

Middle Name

Last Name

Deceased Date of birth

Deceased Date of death

Hour Minutes

Deceased age at time of death

Sex of the deceased

Deceased Weight (roughly)

Deceased Last Address

Street Address

City

State

Postcode

Deceased marital status

Upload: Deceased current drivers license or passport and Medicare.

NEXT OF KIN DETAILS

Next of kin of a deceased adult means, in the following order of seniority:
1. a person who was a spouse or de-facto.
2. where the deceased person has no spouse or the spouse is not available, a son or daughter of the deceased person, who has attained the age of 18 years
3. where no person referred to in 1 or 2 is available, a parent of the deceased person
4. where no person referred to in 1, 2 or 3 is available, a brother or sister of the deceased person, who has attained the age of 18 years

Next of kin full name

First Name

Middle Name

Last Name

Next of kin Date of birth

Next of kin relationship to Deceased

Next of kin email

Next of kin contact number

Area Code

Phone number

Next of kin Address

Street Address

City

State

Postcode

Upload : Next of kin Drivers License, passport or Photo ID .

Name of Hospital /Nursing Home or Residence where the deceased is to be picked up?

Please advise which grave-site you wish to facilitate Rookwood, Kemps Creek, or other?

If you have previously purchased a grave at Rookwood or other cemetery, and you want to request a reopen. Please provide the following-Name of deceased previously buried (Please be advised a re-open takes up to 4 hours.)

Please provide the following

What is the Burial section number?

What is the block and zone ?

What is the grave number?

Full name of previous deceased: (The owner name must be the same name of the next of kit if the owner is still alive)

Date of burial

Full name of the owner of the grave

Kindly advise if you would like Sydney Islamic Funerals Parlour to provide a Sheikh to attend the Funeral Service. (No Sheikh attending if the funeral for baby miscarriage)

Additional Comments.

Sign to give us authority to collect the deceased.