I (full names and surname),
ID.no. residing at
, contact number
and (relationship) of the deceased
(full names and surname)
ID.no. on behalf of the
(surname) family hereby authorise the appointment of STRYDOM BEGRAFNISDIENSTE
(funeral parlour / undertaker), business address 33 Adderley Street, Oudtshoorn
as the representative to register the death at Department of
Home Affairs.
...................................................
Signature of family member
Date:
...................................................
Signature of appointed funeral undertaker
Name: STRYDOM
Date:
| Company name | STRYDOM FUNERALS |
| Registration Number | 2015/186495/07 |
| Contact number | 044 279 1009 |
| Email address | strydomfuneralhome@gmail.com |
| Physical address | ADDERLEY STREET 33 OUDTSHOORN |
This letter serves as proof that STRYDOM FUNERALS will be conducting the burial service for:
| Identity Number | |
| Name & Surname | |
| Date of Death | |
| Date of Burial | |
| Location of Burial | |
| Society Name |
The details of the burial is as follows: The burial service for , who passed away on , is scheduled to take place on at .
If you require any additional information or documentation, please do not hesitate to contact us.
STRYDOM FUNERALS
Printed on:

Deceased:
ID Number:
Date of birth:
Date of death:
Informant / Applicant:
Relationship:
I hereby give permission for the cremation arrangements to proceed.
Signature: ________________________ Date: ____________________

Deceased:
ID Number:
Date of death:
Doctor Name: ____________________________
Practice Number: _________________________
Signature: _______________________________ Date: ____________________