A Basic Service

St. James' Cemetery and Crematorium

THE CHAPEL OF ST. JAMES-THE-LESS

ST. JAMES' CONSECRATED 1845 – CREMATORIUM ADDED 1948

635 Parliament Street, Toronto, ON M4X 1R1

Telephone: 416-964-9194 Fax: 416-964-3279

E-mail: cemetery@stjamescathedral.on.ca

Office Hours: Mon-Fri. 8 a.m. to 4:30 p.m., Sat. 8 a.m. to Noon

APPLICATION FOR CREMATION

(PLEASE COMPLETE BOTH PAGES)

I, ……………………………….….……………………… Telephone ……………………..…………….……...……………

(Name of Applicant)

Address ………………………………………………………………………………………………..……………...…….…….

Apply to the ST. JAMES' CEMETERY and CREMATORIUM to undertake the cremation of the remains of the late

………………………………………………………………………………………………………..……………………..……….

(Name of Deceased)

1. Address of residence of the deceased…….....…………………………………………….………..………

2. Occupation of the deceased ……………..…………………....…………..………………..…………...……

3. Age …………. 4. Sex …..……… 5. Birth Place ……..………...…… 6. Date of Birth……………………..

7. Marital Status of Deceased ……………...............................................................……………………………….

(Whether married, widow, widower, divorced or separated)

Note: If separated, legal spouse must still sign this application unless there is an executor

8. Place of Death....………….…. 9. Date of Death ……………………….….. 10. Hour of Death ……………....………..

11. Are you an executor (or executrix) of the deceased? YES________ No____________

2. If not, state:

a) Did the deceased leave a will? Yes__ No__

(b) Your relationship to the deceased ………..……..……….

c) Are you the nearest surviving relative of the deceased? Yes___ No___

d) The reason why the application is made by you and not by an executor (or executrix) or nearer

relative ……………………………………………………………………………………………………...………..

13. Name and address of the spouse of the deceased ………….………………………………….…………..

14. Did the deceased leave any written directions as to the mode of disposal of his/her remains?

………………………………………………………..…….

If so, what? ……………………………………………………………………………………….…………………...…

15. Have the near relatives and the executor (or executrix) of the deceased been informed of the proposed cremation?

………………………………………………………………………………………………………………………….……………..

( The term "Near Relative" as here used includes: widow, widower, parents, children over the age of 16 years and o other relatives usually residing with the deceased.

16. Has any one expressed any objection to the proposed cremation? ……………..….........................................

17. If so, give the name, address and relationship of that person, and the grounds on which they have made objection.

……………………………………….......................……………………………………………………………………….…….

18. Name of ordinary medical attendant of the deceased……..………………………………………………..………

C

CREMATION is a technical process of reducing the human body to its basic elements of bone fragments

through heat and evaporation. Recoverable cremated remains are separated from any metal residue and

are further mechanically reduced and placed in a cremation urn or container.

a ) I understand that due to the nature of the cremation process, personal possessions and valuable materials will not be recoverable.

b) Under no circumstances will any member of the crematorium or cemetery staff open the casket or container.

c) Caskets or containers must be made of wood or other combustible material as the body is always cremated in the casket/container as received by the crematorium. (Non-flammable, hazardous and prescribed material is prohibited by legislation). Exterior hazardous or non-combustible handles and hardware are removed before cremation and reduced to make them unusable. I give permission for St. James’ Cemetery and Crematorium to recycle the unusable exterior handles and hardware removed.

YES_____ NO_____

I, hereby certify that I have read and understand the foregoing information and that it is true and correct to the best

of my knowledge and belief.

Dated this ……………………………..…………………..…… day of ……………..……………………..…………. 2007

…........................…………...…………………… ………..……….…………………..…………………………

(Witness) (Applicant)

RELEASE REMAINS TO:

FUNERAL HOME: A Basic Service

1403A Bayview Ave.. Toronto, Ontario M4G 3A8 – 416-226-2480

INSTRUCTION FOR DISPOSITION

19. I authorize bestowal of the cremated remains in the following manner, and I agree to pay any

additional charges relevant to this authorization.

In the case of interment or inurnment, I also undertake to provide the written authority of the registered owner of the space in which these cremated remains are to be placed. Failure to provide such authority may be construed as permission for the crematorium to inter in Common Ground in the cemetery in which the cremation took place.

Note Instructions for the disposal of these cremated remains must be given on this application. Otherwise a deposit equal to the prevailing burial charge for common ground will be required, and the remains may be interred in such ground one year after cremation. There will be no refund of deposit after one year.

Cremation Urn …………………………………. Supplied By ………………………………………..

Inter in __ Grave …………. Lot ……………..… Section ………………………………….

__ Family Present………………………….………………………....……….……..

__ Niche No……….. Tier …………………Bay…………. Section……………..

__ Common Ground (Memorial or floral tributes not permitted)

Release to ………………………………………………………………….………..…………..……….

(Designate who is to receive the cremated remains)

A Basic Service

Send to Name …………………………………..…………………………………………..……….

Address ..…………………………………………………………..……………………….….…….

I hereby certify that I have read and understand the foregoing information, and that I have the right to authorize the disposition of the cremated remains and I agree to hold the crematorium harmless against any loss or liability resulting from this authorization and any loss by carrier or recipient.

…………...............................……………… ………………………..………………………

(Witness) (Applicant)

PAYMENT

INVOICE FUNERAL HOME:___

A BASIC SERVICE 1403A BAYVIEW AVENUE TORONTO ONT. M4G 3A8

SOCIAL SERVICES BA/FA # ___________________ OTHER: (EXPLAIN) ………………………………