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(Submission of this form constitutes Written Authorization)
Authorization is given to Hall Davis & Son Funeral Service, Ltd., including its agents, employees, trade embalmers, or any apprentices or students, (including those from a mortuary school, who are under the direct supervision of a licensed embalmer) whether at this location or another location to embalm the remains of the deceased.
The person submitting hereby represents that he/she or they have the legal right to make this authorization.