|
Local Virginia Sheriff's Department:
(Duty To Remove Body, Va. Code §
32.1-288)
__________________________________________________ Fax to: _____________________
FAX TO 804-371-8595
Sender's Name: __________________________________________
Sender's Voice Phone: _____________________________________ Sender's Fax Number: _____________________________________ Sender's Relationship to Decedent: _____________________________________ |
| Decedent's Name:
Date Of Birth: _____________ Date Of Death: _________________ Social Security Number: ______________________ |
| Location of Remains:
Contact: _____________________________ Telephone: ____________________ |
| Known Family Members' Names, Telephone Numbers:
|
| Cause of death if known: Known communicable diseases: |
| Any applicable Guardianship / Conservatorship Order for the deceased is attached or will be forthcoming. |