STRYDOM VORMS

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DEPARTMENT OF HOME AFFAIRS

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:

Left thumbprint of family member
Funeral Parlour stamp

BURIAL CONFIRMATION

Company nameSTRYDOM FUNERALS
Registration Number2015/186495/07
Contact number044 279 1009
Email addressstrydomfuneralhome@gmail.com
Physical addressADDERLEY 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: ____________________