Social Services Policy on Financial Assistance

It is our policy that no one be denied a proper and dignified cremation due to financial limitations. City and town welfare departments provide financial assistance for deceased residents who are indigent, or whose immediate family members do not have the ability to pay for a cremation.  It is the family’s responsibility to request financial assistance from the agency.  Once the agency has approved the request for financial assistance and the amount to be paid in writing, we will apply this amount towards our discounted cremation fee of $1,000 offered to those in need. While many welfare departments pay $1,000 as a benefit, some pay less. If the city or town benefit does not cover our discounted charge, then the balance will need to be paid by the family, person in charge of arrangements or other parties prior to the cremation taking place. Please be aware that we significantly discount our fees in order to be able to provide this community service and are not able to accept less then $1,000. There are four steps to begin the process.

  1. Notify us of the passing of your loved one and that financial assistance will be needed
  2. Contact the welfare department in the city or town where your loved one resided and apply for benefits Click here
  3. Designate one family member to be the contact person with whom we will work
  4. Complete the following form below in its entirety (including the on-line signature) and submit it to us.

Once approved for welfare assistance in writing and any balance due from the family has been paid, our firm will perform the following:

  • Transfer the deceased from the place of death anywhere in New Hampshire into our care
  • Provide shelter and refrigeration prior to the cremation
  • Perform the cremation
  • Secure necessary paperwork, file the death certificate and notify Social Security of the death
  • Provide the cremated remains back to the family in a temporary cardboard container

It is the family’s responsibility to handle the following on their own:

  • Writing up and submitting obituary notices to newspapers
  • Filing for veterans benefits including a flag, military honors, urn burial and cemetery marker
  • Coordinating a memorial service at a church or cemetery
  • Arranging for the delivery and burial of the cremated remains at a cemetery
  • Purchasing certified copies of the death certificate (available at any city or town hall in New Hampshire)
  • Placing cremated remains in an urn or keepsakes purchased from third parties

We regrettably are not able to offer any of the following:

  • Public or private viewing prior to cremation, or family witnessed cremation
  • Use of our facility and/or staff for a memorial service or gathering
  • Urn, keepsakes, pendants, memorial book, cards, or other merchandise

Special Circumstances

  • If the death occurs outside NH, there will be additional transportation and coordination fees
  • If the deceased is at another funeral home, the family will be responsible for paying any fees incurred
  • If the deceased weighs over 350 pounds, additional crematory charges will be incurred

 

This is a legal document. It contains important provisions concerning cremation. Read this document before signing.

 

Vital Statistics

* Were you assigned a Counselor?

* Name of Assigned Counselor:  

Deceased Information

*First Name:   Middle Initial :   *Last Name:

Legal Street Address:   Apt/Suite:  

City:   State: Zip:  

Sex:
     

Marital Status:
         

Date of Birth:

City of Birth: State/Country of Birth:

Social Security Number: Race:

Education (Years Completed): Veteran:      

Occupation (Current or last):   Employer (Current or last):

 

Spouse/Parental Information

Spouse First Name: Spouse Last Name:

Spouse Deceased?      

Father First Name: Father Last Name:

Father Deceased?      

Mother First Name: Mother Maiden Name:

Mother Deceased?     

 

Next of Kin Information

*Next of Kin: Relationship To Deceased:

*Next of Kin Telephone #: Next of Kin E-mail:

Next of Kin Street Address: Next of Kin Apt/Suite:

Next of Kin City: Next of Kin State: Next of Kin Zip:

 

Please enter any additional comments below:

 

Cremation Authorization

AUTHORIZATION FOR CUSTODY, CREMATION AND FINAL DISPOSITION

By submitting this form, I hereby authorize and request the Cremation Society of New Hampshire, in accordance with its rules and regulations, and any applicable laws or regulations, to take possession of, to cremate and to carry out the final disposition of my remains as instructed below.

 

Disclosures Concerning the Cremation Process

It is the policy of the Cremation Society of New Hampshire to provide information concerning the cremation process so that our client families and friends are fully informed. These disclosures are provided in the interest of satisfying any questions and allaying any concerns you may have.

The cremation, processing and disposition of the decedents remains will be performed in accordance with New Hampshire Revised Statutes Annotated 325-A, New Hampshire Code of Administrative Rules Chapter He-P 600, and any and all other governing rules and the policies, procedures and requirements of the Cremation Society of New Hampshire.

Cremation will only take place after all of the following conditions have been satisfied: (a) all scheduled ceremonies and viewing have been completed; (b) at least 48 hours have transpired since the death occurred (no waiting period is required in the case of death resulting from a contagious or infectious disease and the Cremation Society of New Hampshire reserves the rights to perform the cremation thereafter according to its own schedule); (c) the burial permit has been received along with a copy of the signed death certificate and cremation authorization form; (d) the decedent has been viewed by a State appointed medical examiner or assistant examiner and the medical examiner certificate has been signed (e) the deceased had been wrapped in a leak proof pouch and placed in the cremation container, as selected; (f) no objections concerning the cremation have been raised; and (g) the cremation and our charges have been paid in full.

Cremation is performed by placing the deceased in a cremation container and then placing the container into a cremation chamber or retort, where they are subject to intense heat and flame. Through the use of natural gas, incineration of the container and its contents is accomplished and all substances are consumed or driven off, except bone fragments (calcium compounds) and metal (including dental gold and silver and other nonhuman materials) as the temperature is not sufficient to consume them. The Cremation Society of New Hampshire, at its sole discretion, reserves the right to remove all noncombustible materials before cremation and discard them in a nonrecoverable manner. Due to the nature of the cremation process any personal possessions or valuable materials, such as dental gold or jewelry (as well as body prosthesis or dental bridgework), that are left with the deceased and are not removed from the container prior to cremation will be destroyed or if not destroyed, will be disposed. Following a cooling period, the cremated remains, which will normally weigh several pounds in the case of an average size adult, are swept or raked from the retort. The Cremation Society of New Hampshire makes every reasonable effort to remove all of the cremated remains from the retort, but it is impossible to remove all of them, as some dust and other residue from the process is always left behind. In addition, while every effort is made to avoid commingling, inadvertent or incidental commingling of minute particles of cremated remains from the residue of previous cremations is possible.

After the cremated remains are taken from the retort, all noncombustible materials (insofar as possible) are separated and removed from the human bone fragments by visible or magnetic selection and are disposed of in a non-recoverable manner. When the cremated remains are removed from the retort and after they have been separated from other material, they are then mechanically processed (pulverized). This process of crushing or grinding may cause incidental commingling of the remains with residue coming from the processing of previously cremated remains. These granulated particles will be virtually unrecognizable as human remains.

 

Please check if any of the following are present:

Pacemaker
Defibrillator
Prostheses
Silicon Implants
Other Implants

* By checking this box and submitting this form I indicate I have read and fully understand this document and the disclosures associated with it, and that a general price list has been made available to me. My electronic signature authorizes cremation as well as payment.

By submitting this form I indicate I have read and fully understand this document and the section entitled "Disclosures Concerning the Cremation Process" including the paragraphs regarding the processing of the cremated remains and the disposition of gold or silver, bridgework or other dental material, jewelry or mementos that are not removed prior to the Cremation Society of New Hampshire taking custody of the remains. Whoever is responsible for my final disposition must carry out my legally binding wishes as set forth in this document in which I have made known my full intentions.

 

Disclosures Concerning Charges

Charges are only for those items you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain the reason in writing below and on the itemized statement which you may print out upon completion of this transaction and which you will receive at the time of services. Legal, cemetery, crematory, or other requirements compelling the purchase of any item listed herein: - crematory required suitable solid cremation container for cremation which is already included at no charge in all of our cremation packages.

 

Acknowledgement and Agreement

I hereby acknowledge that I have the legal right to make the arrangements for the services selected. I acknowledge that I have been offered for review, either on-line or in print, the General Price List. A copy of this price list is available on this website for review and for download and will also be provided to you in hard copy at the time of services.

 

Electronic Signature: (In accordance with RSA 294-D New Hampshire Digital Signature Act):

* Full legal name of individual authorized to make cremation arrangements


*Please type the full name a second time to confirm

Acceptance

This establishment agrees to provide services, merchandise and cash advancement as selected by the above signed and as reflected on the statement of goods and services.

Arthur Phaneuf, President

Tuesday, October 17, 2017

Please click on the button to submit this form only once and be patient as it might take a few moments to submit the form.

 

243 Hanover Street, Manchester, NH 03104 ~ 172 King Street, Boscawen, NH 03303 ~ 101 Union Street, Littleton, NH 03561
~ 861 Lafayette Road, Hampton, NH 03842
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