Ex Parte Petition For Court Order To Release Remains Of A Page 2
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25.
To the best of my knowledge, Decedent is survived by (check all that apply):
a.
Spouse
f.
Brothers or Sisters
b.
Registered Domestic Partner
g.
Grandparents
c.
Child(ren), Natural or Adopted
h.
Aunts or Uncles
d.
Grandchild(ren)
i.
Cousins
e.
Parent or Parents
j.
No Next of Kin (if this box is
checked, skip to question 8 below).
6.
Listed below are all of the decedent’s known relatives, their relationship(s) to the decedent,
approximate age(s), address(es) and phone number(s):
7.
I have made the following attempts to contact decedent’s relatives to inform them of my request
to claim the decedent’s remains (describe below):
8.
Decedent has no living relatives. I know this because (describe below, for example, “The
decedent told me many times that he had no relatives,” or “I have known the decedent for 10
years and she never spoke of having any family.”):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.
Date:
Petitioner’s Signature
Type or Print Petitioner’s Name
Ex Parte Petition for Order to Release Remains
PRO 017
Health & Safety Code § 7105
02/12
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