The undersigned, having viewed the above digital image of the remains, does hereby identify the same as the body of:*
Ample time has been given the undersigned to assure proper identification prior to the execution of this document and by signing same; the undersigned acknowledges that there is no doubt or question about this identification.

The undersigned assumes all liability for incorrect identification and does hereby agree to indemnify, defend and hold the crematory identified below and its officers, agents and employees, harmless from any and all claims, damages, liabilities and cost (including reasonable attorney’s fees) which may arise if this identification is:
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CREMATORY: CREMATION SERVICES OF SOUTHWEST MICHIGAN
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CREMATORY: CREMATION SERVICES OF SOUTHWEST MICHIGAN