All Faiths Funeral Services 4360 South Congress Avenue, Suite 115

Austin, Texas 78745 Phone: (512) 326-8878 / Fax: (512) 326-8164

website: www.allfaithsbasic.com

Required Cremation Documents

Please call (512) 326-8878 upon receipt of these documents so that one of our Funeral Directors can give you some instructions on how to complete these forms. Thank you for choosing All Faiths Funeral Services. We sincerely appreciate you allowing us the opportunity to serve you and your family. As a low-cost, privately owned business, we have served the Austin and Central Texas area for over 15 years with quality, dignified funerals and cremations that are affordable for all families. The following forms and documents are included: 1. Vital Statistic Form – this form is for the information required to complete the Texas Death Certificate 2. Appointment of Agent – this form names a person to handle the disposition of remains in the event of death; this form must be signed, prior to the death, and in front of a notary public or attorney. 3. Cremation Authorization Form – this form must be completed and signed in front of a Notary Public; although Texas law states only one surviving child/other next of kin is necessary to sign, we require all of the legal next of kin’s signatures. 3. Supplemental Form for Cremation Authorization – addendum for Cremation Authorization Form 4. Authorization to Embalm at Funeral Home or Other Establishment – this form must be signed at the bottom (highlighted area) to say that you are refusing embalming 5. Travis County Medical Examiner Release Form – this form must be completed 6. General Price List – this document is for your review and retention.

FAX ALL COMPLETED FORMS TO (512) 326-8164

WE WILL FOLLOW UP WITH YOU VIA TELEPHONE.

VITAL STATISTIC FORM NOTE: PLEASE COMPLETE THIS FORM IN ITS ENTIRETY. DO NOT OMIT OR DELETE ANY INFORMATION. YOUR FAILURE TO COMPLETE THIS INFORMATION WILL DELAY THE DEATH CERTIFICATE PROCESS AND DELAY THE CREMATION.

DECEASED INFORMATION:

First Name: ________________________ Middle: ______________________ Last: ___________________

If Female, Maiden Name: ______________________________ Age: ___________ Sex: _____________

Date of Birth: _____________________________ Birthplace: ______________________________________

Social Security: ____________________________ Veteran? YES NO Branch: _______________________ (If Veteran, please fax us DD214 or Discharge)

Marital Status: (Circle One) MARRIED WIDOWED DIVORCED NEVER MARRIED

Surviving Spouse (If female, list maiden name): _________________________________________________

Deceased Residence: ________________________________________________________________________

City: _________________________ County: _______________________ State: _________Zip: ____________

Inside City Limits?: YES NO

Deceased Father’s Name: ____________________________________________________________________

Deceased Mother’s Name (List Maiden Name): __________________________________________________

Deceased Occupation (Do Not List Retired): ____________________________________________________

Industry or Type of Business: ___________________________________________________________

Deceased Level of Education: (Select One): ____Less Than 8th Grade ____9th – 12th Grade (No Diploma)

____ HS Diploma or GED ____ Some College, No Degree ___Bachelors ___Masters ___Doctorate

Race: ___________________________ Of Hispanic Origin?: YES NO

Ever serve as a Peace Officer in Texas?: YES NO

Family Contact: ________________________________________ Relationship: ________________________

Address: __________________________________________________________________________________

City: __________________________________ State: __________________ Zip: ____________________

Phone: (_____)_______________________________ Cell: (_____)_______________________________

Email: ____________________________________________________________________________________

APPOINTMENT OF AGENT TO CONTROL DISPOSITION OF REMAINS

I,________________________________________________________________________________________, (your name and address)

being of sound mind, willfully and voluntarily make known my desire that, upon my death, the disposition of my remains shall be controlled by ______________________________________________________________

(name of agent) in accordance with Section 711.002 of the Health and Safety Code and, with respect to that subject only, I hereby appoint such person as my agent (attorney-in-fact). All decisions made by my agent with respect to the disposition of my remains shall be binding.

SPECIAL DIRECTIONS: Set forth below are any special directions limiting the power granted to my agent: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ AGENT:

Name:________________________________ Address:__________________________________________

Telephone Number:_______________________________________________________________________

Acceptance of Appointment:________________________________ Date of Signature:_________________ (signature of agent)

SUCCESSORS: If my agent dies, becomes legally disabled, resigns, or refuses to act, I hereby appoint the following persons (each to act alone and successively, in the order named) to serve as my agent (attorney-in-fact) to control the disposition of my remains as authorized by this document:

1. First Successor Name:_________________________________ Address:_____________________________________

Telephone Number:___________________________________________________________________

Acceptance of Appointment:________________________________ Date of Signature:_______________ (signature of first successor)

2. Second Successor Name:_________________________________ Address:_____________________________________

Telephone Number:___________________________________________________________________

Acceptance of Appointment:________________________________ Date of Signature:_______________ (signature of second successor)

DURATION: This appointment becomes effective upon my death. PRIOR APPOINTMENTS REVOKED: I hereby revoke any prior appointment of any person to control the disposition of my remains.

RELIANCE: I hereby agree that any cemetery organization, business operating a crematory or columbarium or both, funeral director or embalmer, or funeral establishment who receives a copy of this document may act under it. Any modification or revocation of this document is not effective as to any such party until that party receives actual notice of the modification or revocation. No such party shall be liable because of reliance on a copy of this document.

ASSUMPTION: THE AGENT, AND EACH SUCCESSOR AGENT, BY ACCEPTING THIS APPOINTMENT, ASSUMES THE OBLIGATIONS PROVIDED IN, AND IS BOUND BY THE PROVISIONS OF, SECTION 711.002 OF THE HEALTH AND SAFETY CODE.

Signed this ________________ day of ___________________________, 20____.

_______________________________________________________ (your signature)

State of ____________________ County of ___________________ This document was acknowledged before me on _________________________________________ (date) by

____________________________________ (name of principal).

______________________________ (signature of Notary Public)

______________________________

(Seal, if any, of notary) (printed name)

My commission expires:

_________________________________

DEATH CERTIFICATE COPIES Cost is $21 for the first copy and $4 for each additional copy

Please order _______ copies of the Death Certificate.

CREMATION PROCESS

The following must occur before the cremation process can take place under normal circumstances:

1. The DEATH CERTIFICATE must be completed and signed by the certifier (Doctor, Medical

Examiner, or Justice of the Peace), which has up to 5 days to return the certificate to the funeral home

once delivered.

2. An AUTHORITY TO CREMATE must be issued by the Medical Examiner or Justice of the Peace in

the jurisdiction of death.

3. A properly completed, signed DEATH CERTIFICATE must be filed with the local registrar.

4. A BURIAL TRANSIT PERMIT must be obtained from the local registrar.

Once all documents are in the possession of the funeral home, the cremation can be arranged.

The funeral home will make every effort to complete the cremation arrangements as timely as possible. The

average time from the date that ALL of the requested documents have been received by the funeral director to

the completion of cremation is approximately 5 to 7 business days. However, the funeral home is not

responsible for circumstances beyond our ability to control, such as: crematory schedule, doctor’s/certifier’s

availability, holidays, weather, etc.

I acknowledge that I have read the above information. I understand that cremation cannot occur until all

documents and permits are secured as stipulated by Texas law.

Signature: __________________________________ Date: ________________________ (Legal Next of Kin)

SIGNING THE CREMATION AUTHORIZATION FORM Texas Health and Safety Code Section 711.002(a) states that “unless the decedent has left directions in writing for the disposition of the decedent’s remains, […] the following persons, in the priority listed, have the right to control the disposition, including cremation, of the decedent’s remains”:

1. Appointed Agent named in an approved notarized document

2. The decedent’s surviving spouse

3. Any one of the decedent’s surviving adult children

4. Either one of the decedent’s surviving parents

5. Any one of the decedent’s surviving adult siblings

6. Any adult person in the next degree of kinship in the order named by law to inherit the estate of the

decedent.

PLEASE COMPLETE THE FOLLOWING SECTION COMPLETELY

I certify that the Deceased had the following survivors who may, by law and in the order given as stated in the Texas Health and Safety Code Section 711.002, control disposition. (Note: The person by the first YES answer is the person who must sign the Cremation Authorization Form) *Appointed Agent: □ Yes □ No Name: ________________________________________________ Spouse: □ Yes □ No Name: ________________________________________________ Adult Children: □ Yes □ No How Many? ___________________________________________ Names: ________________________________________________________________________________ _______________________________________________________________________________________ Parents: □ Yes □ No Names: _______________________________________________ Adult Siblings: □ Yes □ No Names: _______________________________________________ Other Names and Relationships: _______________________________________________________________________________________ _______________________________________________________________________________________ * The Appointed Agent must be named in an approved document written and signed by the deceased,

signed by the Agent, and approved by a Notary Public.

Onion Creek Memorial Park Inc. Same Ownership as All Faiths Funeral Services

AUTHORIZATION FOR CREMATION AND DISPOSITION NOTICE: THIS IS A LEGAL DOCUMENT. IT CONTAINS IMPORTANT PROVISIONS CONCERNING CREMATION. CREMATION IS IRREVERSIBLE AND FINAL. READ THIS DOCUMENT CAREFULLY BEFORE SIGNING.

I/We the undersigned, having been given ample time to review the remains, do hereby positively identify the same as that of the body of _____________________________________ (hereinafter referred to as the Deceased) who died at (Time)__________, County and State of ________________________________ on the day of __________________________, 20_____ and authorize Onion Creek Memorial Park, Inc. (hereinafter referred to as the Crematory) to arrange cremation of said remains, and certify, warrant and represent that I/We have the full legal right and authority to authorize the cremation, processing and disposition of the remains of the above named Deceased. (□ I/WE ARE NOT AWARE OF ANY PERSON WITH A SUPERIOR OR EQUAL PRIORITY RIGHT) OR (□ PLEASE REFER TO SUPPLEMENTAL FORM, ITEM A)

Have arrangements been made by the Authorizing Agent for an identification viewing of the deceased person before the cremation?

□ Yes □ No If YES, please give the date and time of the viewing as scheduled with the Funeral Director.

Date: ____________________ Time: _______________ ( )a.m. ( )p.m. I/We hereby request and authorize _______________________ Funeral Home (hereinafter referred to as the “Funeral Home”) to take possession of and make arrangements for the remains of the Deceased at Onion Creek Memorial Park, Inc. I/We understand that the services and obligations of the Crematory shall be fulfilled when the instructions for the disposition of the cremated remains have been fulfilled. I/We hereby authorize the Funeral Home/Crematory to arrange for the disposition of the cremated remains of the Deceased as follows:

□ Description of urn or container selected: _______________________ Suitable for shipping: □ Yes □ No

□ Deliver to ____________________________________________________________________________ Cremated remains will be released only to the above designated family member(s) or an authorized family representative

□ Release to _________________________________________ Relationship _________________________

□ Address _______________________________________________ Phone No. ______________________

□ Ship via ______________________________________________________________________________

□ To: Name ___________________________ Address: __________________________________________

□ Other ________________________________________________________________________________

The cremation, processing and disposition of the remains of the Deceased authorized herein shall be performed in accordance with all governing laws, the rules, regulations and policies of the Crematory and Funeral Home, and the following terms and conditions:

1. The remains of the Deceased will not be accepted for cremation unless received by the Crematory in a combustible, leak resistant, rigid cremation container. The Crematory is authorized to remove and dispose of handles, ornaments and any other non-combustible items attached to the cremation container prior to cremation.

2. Mechanical or radioactive devices implanted in the remains of the Deceased (such as pacemakers, etc.) may create a hazard when placed in the cremation chamber. The Crematory will not cremate any human remains which contain any type of implanted mechanical or radioactive device. In the event the remains of the Deceased contains such a device, I/We hereby authorize the Funeral Home, its agents and employees, to remove any such mechanical devices from the remains of the Deceased prior to cremation, and dispose of such items at its discretion. I/WE HEREBY CERTIFY THAT THE REMAINS OF THE DECEASED DO DO NOT CONTAIN ANY TYPE OF IMPLANTED MECHANICAL OR RADIOACTIVE DEVICE. Please initial one

Listed below are all implanted mechanical and radioactive devices which the Funeral Home is authorized to remove from the remains of the Deceased prior to cremation, and dispose of as indicated:

______________________________________ _____________________________________________ Description of Implanted Device Disposition If no instruction for disposition is given, such items may be disposed of at the discretion of the Funeral Home and/or Crematory.

Page 1 of 3

All Faiths

3. The cremation container containing the remains of the Deceased will be placed in the cremation chamber and will

be totally and irreversibly destroyed by prolonged exposure to intense heat and direct flame. I/We authorize the Crematory to open the cremation chamber during the cremation process and reposition the remains of the Deceased in order to facilitate a complete and thorough cremation.

4. Certain items, including, but not limited to, body prostheses, dentures, dental bridgework, dental fillings, jewelry, and other personal articles accompanying the remains of the Deceased, may be destroyed during the cremation process. I/We further authorize that if any items, other than the cremated remains of the Deceased, are recovered from the cremation chamber, they may be separated from the cremated remains of the Deceased and disposed of by the Crematory.

5. I/We hereby authorize the Crematory to separate and remove from the cremation chamber all noncombustible materials, including, but not limited to, hinges, latches, nails, jewelry and precious metals, and to dispose of such materials.

6. Following cremation, the cremated remains of the Deceased, consisting primarily of bone fragments, will be mechanically pulverized to an unidentifiable consistency prior to placement in an urn or other container.

7. Unless an urn or container suitable for shipment is purchased, the Crematory will place the cremated remains of the Deceased in a temporary container which would be suitable for shipment. All cremated remains shipped within the United States will be shipped via U.S. Registered Mail, unless otherwise instructed.

8. In the event the urn or container is insufficient to accommodate all of the cremated remains of the Deceased, any excess cremated remains will be placed in a secondary container and will accompany the primary urn or temporary container when released.

9. I/We understand and acknowledge that even with the exercise of reasonable care and the use of the Crematory’s best efforts, it is not possible to recover all particles of the cremated remains of the Deceased, and that some particles may inadvertently become commingled with particles of other cremated remains remaining in the cremation chamber and/or other devices utilized to process the cremated remains. I/We hereby authorize the Crematory to dispose of any such residual particles in any lawful manner it deems appropriate.

10. Unless I/We give specific written instructions in this Authorization, the cremation, processing and disposition of the remains of the Deceased will not be performed in accordance with any particular religious or ethnic customs.

11. In the event the cremated remains of the Deceased remain unclaimed for a period of 30 days, the Funeral Home and/or Crematory shall give written notice to me/us by certified mail at the address(es) indicated below. I/We agree that in the event the cremated remains of the Deceased remain unclaimed for a period of 120 days after the date of such written notification is mailed, the Funeral Home and/or Crematory is authorized and directed to dispose of the unclaimed cremated remains of the Deceased in any lawful manner it may deem appropriate.

12. I/We agree to indemnify, release and hold the Crematory, Funeral Home, their affiliated agents, employees and assigns harmless from any and all loss, damages, liability or causes of action (including attorneys’ fees and expenses of litigation) in connection with the cremation and disposition of the cremated remains of the Deceased, as authorized herein, or my/our failure to correctly identify the remains of the Deceased, disclose the presence of any implanted mechanical or radioactive devised, or take possession of, or make permanent arrangements for the disposition of such remains.

13. Except as set forth in this Authorization, no warranties, expressed or implied, are made by the Funeral Home, Crematory or any of their respective affiliates, agents or employees.

14. I/We understand that this document does not contain a complete and detailed description of every aspect of the cremation process. I/We acknowledge receiving, from the Funeral Home, a copy of the booklet entitled “Cremation Facts” containing additional explanatory information about the cremation process.

Page 2 of 3

SIGNATURE OF PERSON(S) AUTHORIZING CREMATION AND DISPOSITION

I/We warrant that all representations and statements made herein are true and correct, and that I/We have read and understand the provisions contained in this document, and that I/We have received the booklet entitled “Cremation Facts”. Signature ___________________________ Print Name _______________________ __________________ Relationship to Deceased

Address ______________________________________________________ Tel. No. ( ) _______________ Street City State Zip

Signature ___________________________ Print Name _______________________ __________________ Relationship to Deceased

Address ______________________________________________________ Tel. No. ( ) _______________ Street City State Zip WITNESS: ________________________________________ Print Name __________________________ DATE: ________________, 20____

I hereby acknowledge that all signatures are in compliance with Section 711.002 of the Health and Safety Code.

THIS FORM MUST BE SIGNED IN FRONT OF A FUNERAL DIRECTOR OR NOTARY PUBLIC. Signed this ______________________ day of ______________________________, 20______ STATE OF TEXAS COUNTY OF ____________________ This document was acknowledged before me on _______________________________ by

_________________________________________.

____________________________________________ (Signature of Notary Public)

____________________________________________ (Printed Name of Notary Public)

SEAL: My Commission Expires: __________________________

Page 3 of 3

Onion Creek Memorial Park Inc. Same Ownership as All Faiths Funeral Services

SUPPLEMENTAL FORM to AUTHORIZATION for CREMATION Funeral Home ________________________________ Deceased _________________________________ A. ( ) 1. I/we acknowledge that ______________________, relationship _____________________, has an equal priority right to authorize cremation. However, we have made all reasonable efforts but failed to contact this person and believe that this person would not object to the cremation of ______________________________. I/we also agree to indemnify and hold harmless the funeral establishment and crematory establishment for any liability arising from performing the cremation without this person’s authorization. ( ) 2. Please refer to the attached Appointment of Agent to Control Disposition of Remains as outlined in accordance with Section 711.002 of the Health and Safety Code. ( ) 3. I hereby acknowledge that there is no surviving next of kin. I also agree, at my sole expense, to defend, hold harmless and indemnify the funeral establishment and Onion Creek Memorial Park Crematory for any liability suit, cause of action, cost or expense resulting in any way from your reliance on or performance consistent with the directions, declarations, representatives, and agreement to cremate __________________. B. Instructions for the disposition of the following items of value: __________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

C. The following services have been arranged: ____________________________________________

_________________________________________________________________________

_________________________________________________________________________

D. Please outline your plans for final disposition (if known).

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Signature: __________________________ Print Name _________________________ Date _____________

All Faiths Funeral Services

AUTHORIZATION TO EMBALM AT FUNERAL ESTABLISHMENT OR OTHER LOCATION

Name of Licensed Funeral Establishment ___________________________________

Name of Deceased________________________________Date of Death____________

The undersigned, understanding that embalming is not required by law except in certain special cases, authorizes the funeral establishment to utilize a licensed facility under the same general ownership and management or use licensed embalmers as agents or independent contractors or a commercial embalming establishment to care for, embalm, and prepare the body of the deceased. The funeral establishment accepts the responsibility of revealing, upon request, to the next-of-kin or person responsible for making final disposition arrangements, the name, address, and license number of the facility where embalming occurred and the name and license number of the embalmer and any provisional licensee or mortuary student who assisted under the embalmer’s direct supervision. The undersigned authorizes and directs the funeral establishment, including apprentices (provisional licensees), and mortuary students under the direct supervision of a licensed embalmer employed by the funeral establishment, and the funeral establishment’s employees, independent contractors, and agents to care for, embalm and prepare the body of the decedent. The undersigned acknowledges that this authorization encompasses permission to embalm at the funeral establishment or at another facility equipped for embalming, including a school or college of mortuary science. ______________________________________________________Date Signed_____________ Signature of next-of-kin or Person Responsible for making arrangements for final disposition

NOTE: Mortuary Students may only participate in embalming if permission is in writing and in the possession of the Licensed Embalmer at the time of the procedure.

If no authorization can be obtained, complete the following: I hereby acknowledge that _________________________________ has made a reasonable effort over a Name of Establishment period of at least three hours to obtain authorization to embalm the deceased. I take full responsibility for performing embalming without permission. Times contact with family attempted: ______________ ______________ ___________________________________ ______________ Signature and License # of Embalmer

The undersigned, who represents the deceased, hereby declares that having the legal authority to do so, refuses to give permission to embalm the above-named deceased individual. ____________________________________________________________________ Signature Date

If Authorization for embalming is oral, complete the following: Location of embalming disclosure was discussed with next-of-kin or person responsible for making arrangements. Authorization to embalm received from ___________________________________________________ Relationship to Deceased________________________________________________________________ Time____________________________a.m. or p.m. Date____________________________________ Received by___________________________________________________________________________

All Faiths Funeral Services

If your loved one is currently in the care of the Medical Examiner, please fill out the following form:

All Faiths Funeral Services

4360 S. Congress Ave., Ste. 115 Austin Texas

78748

512-326-8878 512-326-8164

All Faiths Funeral Services

Offering Basic Cremations & Burials

4360 South Congress Ave., Ste. 115 Austin, Texas 78745

512-326-8878 Fax: 512-326-8164

Lic. #3086

www.allfaithsonline.com Email: funeraldirector@allfaithsonline.com

General Price List Casket Price List and

Outer Burial Container Price List These prices are effective as of March 6, 2017

and are subject to change without notice.

The following price list meets the necessary requirements of funeral pricing required by the Federal Trade Commission. While there are very specific language and disclosures required from the FTC, we have included additional information in more understandable terms. It is our hope that we help the consumer become educated and not intimidated.

All Faiths Funeral Services PAYMENT POLICY

To lose someone you love is a devastating experience. It is frequently traumatic and can seriously

impact judgment. We believe in the importance of the recognition and meaningful celebration of a life that has

been lived, and will assist in arranging an appropriate service to meet your individual needs.

It is also important to be realistic in respect to funeral expenditures. We do not want a family to spend

more than they should, nor less than they would like. It is important that arrangements are kept within the

family’s wishes and budget.

Provisions for payment are due at the time of arrangements. All prices listed within this General Price List are cash prices. To avoid any possibility of misunderstanding, and for your convenience, we accept the following methods of payment that are approved and verified.

• Cash – Check - Debit Card – Visa – MasterCard – Discover – American Express

• Insurance Assignment of a verifiable policy will be subject to an insurance processing fee of a minimum of $65.00 or 4.75% of the assigned amount, whichever is greater. Due to our low prices,

this will cover the minimum processing fee.

• Advance payment by forwarding or receiving funeral home

• Pre-Arrangement

• For obituaries, family is responsible for all charges for the placement of a paid obituary with a newspaper, as charges may vary per newspaper. Funeral Home is not responsible for any cost or

charges for the obituary.

These prices are effective as of March 6, 2017 and are subject to change without notice. ____________________________________________________________________________________

By signing below, the undersigned acknowledges receipt of the Payment Policy and understands the

financial obligation and responsibility for all charges and costs related to the funeral service.

__________________________________ __________________________________ Undersigned Purchaser Undersigned Purchaser

__________________________________ __________________________________ Date Date

I have given the Payment Policy to the family.

__________________________________ ___________________________________ Funeral Director Date

All Faiths Funeral Services

GENERAL PRICE LIST For Families Desiring an Itemized Selection of Services

4360 S. Congress, Ste. 115 Austin, Texas 78745

(512) 326-8878 (512) 326-8164 FAX

Lic. #3086

These prices are effective as of:

March 6, 2017 but are subject to change without notice.

The Federal Trade Commission Trade Regulation Rules for “Funeral Industry Practices” and the Texas Funeral Service Commission require certain disclosures and prohibit misrepresentations. This form complies with all known requirements of the aforementioned agencies. The goods and services shown below are those we can provide to our customers. You may choose only the items you desire. However, any funeral arrangements you select will include a charge for our basic services and overhead. If legal or other requirements mean you must buy any items you did not specifically ask for, we will explain the reason in writing on the statement we provide describing the funeral goods and services you selected. You may choose only the items you desire. You will be charged for the items you use. If you have to pay for any items you did not specifically ask for, we will explain the reason in writing on the memorandum of the agreement. Please note that there may be charges for items such as cemetery fees, flowers, and newspaper notices. (S.B. 277 66th Legislature) The descriptions “Gasketed” and “Non-Gasketed” are the manufacturers’. Although certain caskets and vaults offered for sale by the funeral provider may be of better quality construction and comprised of more durable material than another, neither the funeral provider nor any of its employees represents or implies that any casket or vault will be water tight or will provide long term preservation of human remains.

ITEMIZED SERVICE SELECTIONS

Basic Professional Services of Funeral Director and Staff $895.00 This is the basic charge to each family that we serve, for our professional expertise in assisting them. It includes, but is not limited to, an appropriate share of the taxes, licenses, utilities and business expenses necessary to serve the public in a professional manner. Also included in this charge is the consultation with the family, clerical and administrative services, local preparation and filing of necessary permits, sheltering of remains, consultation with the clergy, cemetery, crematory, common carrier, assistance with insurance papers, planning the funeral or memorial services, and consulting and submitting of one courtesy obituary notice (free death notice) in a local paper. There will be an additional charge for the direction and supervision of each service requested or required. This fee for our basic services and overhead will be added to the total cost of the funeral arrangements you select. (This fee is already included in our charges for direct cremations, immediate

burials, and forwarding or receiving remains.)

Embalming $625.00 Embalming is a chemical process which provides temporary preservation of the body and eliminates certain health hazards. A person licensed by this state must complete this procedure. Except in certain special cases,

embalming is not required by law. Embalming may be necessary, however, if you select certain funeral

arrangements, such as funeral with a viewing. If you do not want embalming, you usually have the right to

choose an arrangement that does not require you to pay for it, such as direct cremation or immediate burial.

Other Preparation of Deceased: Washing and Disinfecting of Unembalmed Remains $195.00 Dressing, Casketing and Cosmetology $195.00 Hair Stylist $ 85.00 Post Autopsy Care $425.00 Post Organ Donation Care $250.00 Refrigeration Services (per day) $ 75.00 Refrigeration charges will only be incurred if family has not completed all necessary arrangements within five business days. Insurance Assignment of a verifiable policy will be subject to an insurance processing fee of a minimum of $65.00 or 4.75% of the assigned amount, whichever is greater. Please note that additional charges may be incurred for deceased weighing 300 pounds or more.

USE OF FACILITIES AND STAFF

Use of Facilities and Staff for Visitation at Funeral Home $295.00 Our services include coordinating and supervision of visitation at our facility, setup and use of visitation room, and staff in attendance for visitation, up to 4 hours maximum per day. Seating capacity for 15 people.

Additional Visitation Hours (After 4 hour maximum limit. This rate is per hour) $150.00

Use of Staff and Equipment for Visitation, Wake or Rosary at Other Facility $395.00 Our services include coordinating and supervision of visitation at other facility, setup at other facility, and staff in attendance for visitation, up to 4 hours maximum.

Use of Facilities for Limited Visitation or ID viewing $195.00 Our services include set up and use of small viewing room for limited visitation or ID viewing for immediate family only, up to one-half hour maximum.

Use of Facility and Staff for Funeral Service in our Chapel $295.00 Our services include coordinating and supervision of the funeral service, setup and use of chapel, and staff in attendance for funeral service. Seating capacity for 15 people.

Use of Staff and Equipment for Funeral Service at Other Facility $475.00 Our services include coordinating and supervision of the funeral service at other facility, setup, and staff in attendance for funeral service.

Use of Staff and Equipment for Graveside Service at Cemetery $375.00 Our services include transportation to cemetery, supervision of graveside service, and staff in attendance for service, up to 2 hours maximum.

Use of Facility and Staff for Memorial Service in Our Chapel $295.00 For use of our chapel when funeral home has no involvement with care and disposition of remains. Our services include the use of our chapel for a memorial service without remains present (cremated remains in an urn may be present), coordinating and supervising of the memorial service, and staff in attendance for memorial service.

Use of Off-Site Facility (Seating for approx. 100) for Funeral or Memorial Service $395.00

Additional Charge for Use of Facilities and Staff on Sundays and Holidays $625.00

Overnight Fee for Funeral Director or Staff (Traveling more than 175 miles for service) $795.00

AUTOMOTIVE EQUIPMENT AND TRANSPORTATION

Standard Removal and Transfer of Remains to Funeral Home (25 mile radius) $395.00 Deceased weighing 300 pounds or more will have an additional charge for additional personnel to assist in the removal.

Additional Personnel for Removal (only charged due to weight and safety requirements) $200.00

Lead Vehicle / Minister Car $150.00

Funeral Vehicle (Suburban) (25 mile radius) $250.00

Funeral Coach (Hearse) (25 mile radius) $425.00

Limousine (Per vehicle) (25 mile radius) $375.00 Additional limousines are available. Rates and terms will be quoted by limousine service and may require a 3 hour minimum.

Transfer To or From Airport / Crematory $150.00

Transfer To Place of Autopsy $325.00

Additional Transportation Outside of Service Area (25 mi.) Per Vehicle $3.25/mi

ABBREVIATED SERVICE OPTIONS

Forwarding Remains to Another Funeral Home $2,065.00 This charge includes standard removal of remains, basic professional services of staff, necessary authorization, embalming, and local transportation (excluding shipping charge and shipping container; mileage charges will be added for overland transportation beyond 35 mile radius). This charge does not include a casket nor use of

facilities and staff for visitation or ceremonies.

Receiving Remains from Another Funeral Home $1,045.00 This charge includes minimum services of staff and transportation from airport. This charge does not include a

casket nor use of facilities and staff for visitation or ceremonies.

Immediate Burial* (See page 8 for special package pricing) This service includes the basic services of the funeral director and staff; administrative staff for obtaining legal documents; standard removal of the deceased from the place of death to the Funeral Home within a 25 mile radius; sanitary care of the remains and transportation of the deceased to the cemetery for burial in funeral coach. Date and time of burial will be determined by the Funeral Home. This service does not include:

embalming or other preparation of the remains; viewing or other use of facilities for viewing or funeral service;

graveside service; merchandise such as casket, outer burial container, clothing, sundries; or any cash advance

items.

Total Immediate Burial with Casket provided by Purchaser $1,715.00 Total Immediate Burial with Minimum Casket from Funeral Home $2,710.00

BASIC (DIRECT) CREMATION

Basic (Direct) Cremation – No services or Viewing of remains $795.00 This service includes: the service of the funeral director, staff and administrative staff; obtaining legal documents, and other paperwork necessary to complete the arrangements at the funeral home; standard removal of the deceased from the place of death to the Funeral Home within a 25 mile radius; transfer of body to crematory; *standard refrigeration services; *standard crematory fee; return of cremated remains to Funeral Home. This service does not include: viewing; merchandise such as casket or cremation urn; outer burial

container, clothing, sundries, cash advance items, mailing of cremated remains or faxing documents. Death

certificates are to be picked up at Funeral Home.

If you want to arrange a direct cremation, you can use an alternative container. Alternative containers encase the body and can be made of materials like fiberboard or composition materials (with or without an outside covering). The containers we provide are a fiberboard container.

Note: The following must occur before the cremation process

can take place under normal circumstances:

• The Death Certificate must be completed and signed by the certifier (Doctor, Medical Examiner, or Justice of the Peace), which has up to 5 days to return the certificate to funeral home once delivered.

• An Authority to Cremate must be issued by the medical examiner or the Justice of the Peace in the jurisdiction of the death.

• A properly completed, signed Death Certificate must be filed with the local registrar.

• A Burial Transit Permit must be obtained from the local registrar.

**Refrigeration charges will only be incurred in the event final disposition is delayed by choice of family, medical or legal authority. **Crematory fees included in any pricing are a “standard” crematory fee of Onion Creek Memorial Park and Crematory. Remains weighing in excess of 300 lbs. will be subject to additional charges in addition to transportation fees and are subject to the discretion of the crematory. Committal to Flame Ceremony add to Basic Cremation price $350.00 Family may witness the decedent being placed in the crematory chamber. The cremated remains will be released to the family 1-3 business days later.

Basic (Direct) Cremation with container provided by the purchaser with *standard crematory fee $750.00

Basic (Direct) Cremation with Alternative Container provided by Funeral Home $795.00 with standard crematory fee

BURIAL PLANS (Applies to At Need Services Only)

Traditional Funeral Service in South Austin Chapel $5,320.00 This service includes our Basic Professional Services, Standard Removal, Embalming, Dressing and Casketing, Visitation (up to four hours) in South Austin Chapel, Funeral Service in South Austin Chapel, Lead/Minister Vehicle, Hearse and a Matthew Wingate 20 gauge Casket.

Simplicity Funeral Service in South Austin Chapel $5,075.00 This service includes our Basic Professional Services, Standard Removal, Embalming, Dressing and Casketing, Visitation (one hour prior to service) in South Austin Chapel, Funeral Service in South Austin Chapel, Lead/Minister Vehicle, Hearse and a Matthews Valencia 20 gauge Casket.

Graveside Service $4,805.00 This service includes our Basic Professional Services, Standard Removal, Dressing and Casketing, Graveside Service, Hearse and a Matthews Valencia 20 gauge Casket.

Special Immediate Burial Package with Baron Metal Casket See Page 6* $2,900.00 This package includes all services of the Immediate Burial (see page 6) with the Baron standard* metal casket. Casket upgrades are available by paying the difference of the listed prices on our price list.

Mexico Ship-Out Package $3,900.00 This package includes use of facilities and staff for funeral service in our chapel, forwarding remains, courier fee for obtaining international documents and the Baron standard* metal casket. (Oversize caskets are available at additional cost.) Casket upgrades are available by paying the difference of the listed prices on our price list.

CREMATION PLANS

Tribute Cremation Service in South Austin Chapel $3,925.00 This service includes our Basic Professional Services, Standard Removal, Transfer to Crematory, Batesville Ceremonial Oak Casket, Embalming, Dressing and Casketing, Visitation (one hour prior to service) in South Austin Chapel, Funeral Service in South Austin Chapel and Cremation Fee. Memorial Service in South Austin Chapel $2,075.00 This service includes our Basic Professional Services, Standard Removal, Transfer to Crematory, Fiberboard Cremation Tray, Funeral Service in South Austin Chapel, and Cremation Fee.

MERCHANDISE We offer many different styles and prices of caskets and alternative containers from which to select. Since many caskets that appear similar in appearance may differ greatly in quality and construction, we offer the following in order to assist you in making an informed decision. A complete list of caskets offered by this firm will be provided upon request. “Gasketed” – These caskets are designed by the manufacturer to resist the entrance of air, water and other outside elements. They may be constructed of varying gauges of steel, copper and bronze. “Non-Gasketed” – These caskets are not designed by the manufacturer to resist the entrances of air, water and other outside elements. They may be constructed of metal, hardwood or wood products with fabric.

CASKETS

Casket Selection Ranges From $5,200.00 to $995.00 A complete price list will be provided at the Funeral Home

Standard width caskets may not accommodate the weight of some human remains. Additional charges will apply should an oversize casket be required for the human remains.

OUTER BURIAL CONTAINERS

Outer Burial Container Selection Ranges From $3890.00 to $795.00 A complete price list will be provided at the Funeral Home

Disclaimer of Warranty: The only warranty on the casket or any other merchandise sold in connection with this

service is the express written warranty, if any, granted by the manufacturer. This funeral home makes no

warranty, expressed or implied, including an implied warranty of merchantability and an implied warranty

of fitness for a particular purpose, with respect to the casket and/or outer burial container.

GENERAL POLICIES Disinterments – Our minimum professional fee is $895.00. This includes the necessary family conferences, coordinating with the cemeteries, grave service companies, arranging for transportation and obtaining the necessary permits and authorizations. All grave service charges and transportation will be handled as a cash advance (you will be charged only what we are charged). We reserve the right to make additional charges for the professional services which require more of our time. Unembalmed Remains – Texas statutes provide that all decedents not disposed of within 24 hours after death must be embalmed or refrigerated. If you do not want embalming, we can arrange for refrigeration. You may have the funeral service with an unembalmed body present, but under no circumstances will we allow public viewing of an unembalmed body. Viewing of unembalmed remains is restricted to immediate family only (maximum of 10 people). If an autopsy has been conducted, Post Autopsy Care is required for viewing. Viewing of unembalmed remains may not be possible in certain circumstances.

GENERAL MERCHANDISE AND SERVICES

Alternative Containers (minimum fiberboard tray / no interior) $ 45.00 *This container is included in our Basic (Direct) Cremation service.

Urns $ 75.00/up

Clothing $ 95.00/up

Underclothing Sets (included with purchase of suit or dress) $ 35.00

Register Book Starting at $ 40.00/up

Stationery Set Starting at $ 95.00/up

Service Folders / Prayer Cards (100) $ 45.00/up

Acknowledgement Cards (50) $ 20.00

Air Tray $195.00

Combination Shipping Container $250.00

Packaging and Shipping of cremated remains via USPS Registered Mail $ 95.00/up

Mailing Death Certificates via USPS Registered Mail $ 35.00

Express mailing with USPS Plus $ 50.00/up

Crucifix $ 25.00 It is acceptable to purchase multiple crucifixes for several family members

Temporary Grave Marker $ 25.00

Disaster Pouch $ 125.00

Courier Fee for Obtaining International Documents $ 245.00 Service fee for a dedicated courier to obtain and translate necessary documents from city, state, county and

international offices. This does not include the service/document fees charged by above offices.

Service/document fees will be included as a Cash Advance. There may be additional charges for express

mailing, consulate fees, additional mileages to consulate offices, etc.

Custom Casket Panel Inserts $ 175.00/up

Veteran Flag Cases $ 125.00/up

Scattering of cremated remains (within 25 mile radius of Funeral Home) $ 100.00

CASKET PRICE LIST These prices are effective March 6, 2017 and are subject to change without notice.

Premium Metal Selections*

• Masterpiece 16 gauge steel, silver velvet interior $ 5,200.00

• Champagne Rose Stainless steel, pink velvet interior $ 4,395.00

• Sanctuary Stainless steel, blue velvet interior $ 4,395.00

• Burgundy Rose 18 gauge steel, natural velvet interior $ 4,195.00

Standard Metal Selections*

• Garrison Cashmere 18 gauge steel, ivory basketweave interior $ 3,595.00

• Garrison Ebony 18 gauge steel, crème brulee basketweave interior $ 3,595.00

• Springfield Rosebud 18 gauge steel, pink velvet interior $ 3,495.00

• Springfield Silver Pearl 18 gauge steel, silver velvet interior $ 3,495.00

• Springfield Autumn Haze 18 gauge steel, arbutus velvet interior $ 3,495.00

• Springfield London Blue 18 gauge steel, arbutus velvet interior $ 3,495.00

• Pierce Cabernet 18 gauge steel, ivory basketweave interior $ 3,295.00

• Pierce Colonial Pewter 18 gauge steel, ivory basketweave interior $ 3,295.00

• Pierce Cashmere 18 gauge steel, ivory basketweave interior $ 3,295.00

• Patriot Ebony 18 gauge steel, uniform black interior $ 3,095.00

• Patriot Midnight Blue 18 gauge steel, uniform blue interior $ 3,095.00

• Affinity Light Gunmetal 20 gauge steel, white crepe interior $ 3,095.00

• Affinity Light Orchid 20 gauge steel, pink crepe interior $ 3,095.00

• Affinity London Blue 20 gauge steel, silver crepe interior $ 3,095.00

• Affinity Russet Brown 20 gauge steel, rosetone crepe interior $ 3,095.00

• Sterling Antique White 18 gauge steel, pink crepe interior $ 2,895.00

• Sterling Storm Blue 18 gauge steel, blue crepe interior $ 2,895.00

• Essex Ebony 20 gauge steel gasketed, white crepe interior $ 2,595.00

• Essex Spruce Blue 20 gauge steel gasketed, blue crepe interior $ 2,595.00

• Silver Haze 18 gauge steel, white crepe interior $ 2,395.00

• Wingate Copper Haze 20 gauge steel gasketed, rosetone crepe interior $ 2,195.00

• Wingate Silver 20 gauge steel gasketed, white crepe interior $ 2,195.00

• Wingate Dawn Gold 20 gauge steel gasketed, rosetone crepe interior $ 2,195.00

• Wingate Star White 20 gauge steel gasketed, white crepe interior $ 2,195.00

• Valencia 20 gauge steel gasketed, moselle crepe interior $ 1,995.00

• Olivetone 20 gauge steel, rosetan crepe interior $ 1,795.00

• Baron / 85 20 gauge steel, non-gasketed, rosetone crepe interior $ 1,395.00

Hardwood Selections*

• Gatewood Solid Cherry, ivory velvet interior $ 4,795.00

• Provincial Solid Poplar, rosetan crepe interior $ 3,895.00

• 23rd Psalm Solid Poplar, khaki basketweave interior $ 3,495.00

• Augusta Solid Pine, rosetan crepe interior $ 2,895.00

• Endicott Poplar Veneer, rosetone crepe interior $ 2,395.00

• Kinsey Cloth Covered Cardboard, ivory interior $ 995.00

Cremation Caskets*

• Ceremonial Oak Rental Veneer finish with insert $ 1195.00

Alternative Containers*

• Minimum* Fiberboard tray, no interior, unfinished $ 45.00 • Minimum Oversize Fiberboard tray, no interior, unfinished $ 175.00 • Air Tray Fiberboard tray, Airline Approved shipping container $ 225.00 • Combination Shipping Tray Fiberboard tray, Airline Approved shipping container $ 250.00 *Minimum: This container is included in our Direct Cremation service.

Standard width caskets may not accommodate the weight of some human remains. Additional charges will apply should an oversized casket be required for the human remains.

Disclaimer of Warranties Regarding Caskets: Our funeral home makes no representations or warranties regarding the caskets listed above. The only warranties, expressed or implied, granted in connection with caskets sold are the express written warranties, if any, extended by the manufacturers thereof. Our funeral home hereby expressly disclaims all warranties, expressed or implied, relating to the caskets, including, but not limited to the implied warranties of merchantability and fitness for a particular purpose.

OUTER BURIAL CONTAINER PRICE LIST These prices are effective March 6, 2017 and are subject to change without notice.

Concrete Burial Vaults (for standard sized caskets)

• Bronze Triple wall, ABS Fiberlon, Bronze lined interior $ 3,890.00 • Lydian Triple wall, ABS Fiberlon, Copper lined interior $ 3,810.00 • Athena Triple wall, ABS Fiberlon, Stainless Steel lined interior $ 2,610.00 • Patrician ABS Lustra Tech liner $ 1,490.00 • Tiara Polystyrene liner $ 1,250.00 • Titan Polystyrene liner $ 1,150.00

Graveliners

• Concrete liner Concrete liner, non-sealing type, standard 30” interior $ 795.00 In most areas of the country, state or local law does not require that you buy a container to surround the

casket in the grave. However, many cemeteries require that you have such a container so that the grave will

not sink in. Either a grave liner or a burial vault will satisfy these requirements.

Disclaimer of Warranties Regarding Outer Burial Containers: Our funeral home makes no representations or warranties regarding the outer burial containers listed above. The only warranties, expressed or implied, granted in connection with outer burial containers sold are the express written warranties, if any, extended by the manufacturers thereof. Our funeral home expressly disclaims all warranties, expressed or implied, relating to the outer burial containers, including, but not limited to the implied warranties of merchantability and fitness for a particular purpose.

AFFILIATED COMPANIES & SERVICES

Onion Creek Memorial Park

Providing burial and cremation disposition options in a

Natural Texas Hill Country setting 11610 Chapel Lane Austin, Texas 78748

(512) 282-3893 www.OnionCreekMemorialPark.com

All Faiths of the Pines Funerals & Cremations 110 American Legion Road

Smithville, Texas 78957 (512) 237-3836

www.AllFaithsOfThePines.com Lic. #3617

Capitol Monument Company Working with people and cemeteries through

Care, Service and Quality

South Austin 818 FM 1626

Manchaca, Texas 78652 (512) 280-3750

Gonzales (Main Office)

5233 North US 183 Gonzales, Texas 78629

Toll-free: 1-800-637-5182 www.CapitolMonument.com