Notification of the transportation of human remains (Unofficial translation)

––––––––––––––––

(date)

 

No.

Information

1.

Date of transportation of the deceased person

 

(year, month and day)

 

2.

Data of the deceased person being transported

 

(name, surname))

 

(date of death: year, month and day)

 

3.

Data of funeral service provider

3.1

Legal entity

 

(Company name)

 

(company code number)

 

(business address)

 

(phone, e-mail)

 

3.2.

Person

 

(name, surname)

 

(personal number)

 

(business address)

 

(phone, e-mail)

 

4.

Vehicle to transport the deceased person

 

(national registration number)

 

(car brand)

 

(type / variation /version)

 

(commercial name)

 

5.

Purpose of transportation of the deceased person and country of destination

 

 

Funeral

 

 

                      (tick appropriate)

 

Cremation

 

 

                                             (Country)

 

6.

 

Confirmation that the deceased person was not suffering from a highly contagious communicable disease

I confirm that the deceased person was not suffering from a highly contagious communicable disease

 

(tick if correct)

 

7.

Confirmation that there are no restrictions on cremation (to be completed if deceased person is transported for cremation)

I certify that (tick if correct):

 

the person has not expressed his / her disagreement with the cremation of his / her remains in accordance as referred to in Article 3 (2) Law on the Burial of Human Remains of the Republic of Lithuania;

 

 

there is no disagreement between the deceased's close relatives over the cremation of the deceased person as referred to in Article 5 (3) of the Law on the Burial of Human Remains and the cremation company has been informed in writing;

 

 

it is unknown and not suspected that the person's death is a criminal offense and is the subject of a pre-trial investigation;

 

 

the identity of the deceased person is recognized.

 

 

8.

Confirmation of conformity of the vehicle

 

I certify that the deceased person is being transported in a vehicle that complies with the requirements set out by the Government or its authorized body (tick if correct).

 

 

9.

Confirmation that the data provided is correct

 

I certify that the data provided is correct (tick if correct).

 

 

 

 

(position of the chief executive or authorized representative)

 

(name, surname))

 

(signature)

 

(date)

Last updated: 18-12-2019