Upon issuance of the urn to the owner/representative. Golden Haven Inc. is not liable to any damage, breakage, or loss of the said container.

This AGREEMENT is used upon the request of the Unit Owner/Representative of the deceased.

Deceased Details
Description of Urn
Representative Details

I hereby agree to the terms and conditions and consent to the collection, use and disclosure of all personal information I have provided hereunder for the purpose of Golden Haven services rendered and all other documents related hereto.