New Admin View – Treasure Coast Cremations

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Invoice Number	1338
Identification of the Decedent
HTML Block	Name of the Decedent should include First, Middle, and Last Name. Select a Suffix if appropriate. Be sure that this is the legal name that would be on any legal documentation such as a social security card, driver's license and/or bank account. If this information is incorrect, you may have to have your Death Certificates amended and reissued at an additional cost.
Deceased Person	Keith
Name	Keith Joseph Garvey
Legal Residence of Decedent	4522 Brady lane Palm beach gardens, Florida 33418 Map It
Gender	Male
Social Security Number	046-60-9603
Residence within city limits?	No
Decedent's County of Residence	Palm Beach
Date of Birth	07/18/1958
Birthplace	Norwalk, Connecticut
Date of Death	11/04/2022
Place of Death	Residence
Race	White
Hispanic or Haitian Origin?	Not Hispanic or Haitian
Other Information
Is Decedent a Veteran?	Yes
Which branch of armed forces?	Air Force
Industry of Work	Transportation/Logistics
Marital Status	Divorced
Education Level	High School diploma or GED
Does Decedent have a Pacemaker, Implant or Prosthetic?	No
HTML Block	Pacemakers, radioactive, silicon, or other implants, mechanical devices or prosthetics may create a hazardous condition when placed in the cremation chamber and subjected to heat. If the crematory does not receive proper notice, the family and/or undersigned shall be responsible for any damage resulting and the crematory will not be responsible or accept any liability under those circumstances.
Please check the following statement:	As Legally Authorized Person, I instruct the Funeral Home to remove any device which may create a hazardous condition when placed in the cremation chamber and to charge for its services in making or arranging for such removal and disposal.
Decedent's Parents Information
Fathers Name	Thomas Joseph Garvey
Mothers Name	Elizabeth Ann Garvey Fahan
Identification of Legally Authorized Person
Name	Thomas Garvey
Email	Email hidden; Javascript is required.
Phone	(561) 629-4685
Relationship with Decedent	d) Majority Age Child
Mailing Address	4522 Brady lane Palm Beach gardens, Florida 33418 Map It
By checking this box, I certify that the statements above are true to the best of my knowledge.	I agree
Certification	Please certify your relationship to the Decedent.
Legally Authorized Person	The Legally Authorized Person represents that the relationship between the Legally Authorized Person and the Decedent is as follows: Surviving Spouse of the Decedent at time of Death. The person designated by the Decedent in an Antemortem Preneed Authorization form to arrange the cremation. The Executor or Administrator of the Decedent's estate who has written instructions by the Decedent authorizing this cremation. An adult child of the decedent. If the Decedent had more than one surviving adult child, the Authorizing Agent represents that all of the Decedent's other adult children have signed the cremation authorization. A parent of the Decedent or, if the decedent was under the age of 18, the parent, guardian or custodian of the Decedent. If the other parent of the Decedent is still alive, the Authorizing Agent represents that the other parent has been notified of the Decedent's death and of the plans to cremate the Decedent's remains, and has not expressed an objection to the cremation. The person in the next degree of kinship to the Decedent after those listed above (a) through (e). A representative of a nursing home, rest home, adult care facility or hospital which has been designated in a duly executed Antemortem Cremation Authorization as the institution to make arrangements for the final disposition of the Decedent's remains. In the absence of any individual listed above in (a) through (g), an individual willing to assume the responsibility of serving as the Authorizing Agent.
By checking this box, I certify that the statements above are true to the best of my knowledge.	I Agree
HTML Block	382.026 Penalties.— (1) Any person who willfully and knowingly makes any false statement in a certificate, record, or report required by this chapter, or in an application for an amendment thereof, or in an application for a certified copy of a vital record, or who willfully and knowingly supplies false information, intending that such information be used in the preparation of any such report, record, or certificate, or amendment thereof, commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
The Cremation Process	The cremation of the Decedent’s remains may take place before or after ceremonies to memorialize the Decedent. Cremation is performed to prepare the remains of the Decedent for final disposition. It is carried out by placing the Decedent’s remains in the casket or alternative container, which is then placed into a cremation chamber where they are subjected to an intense heat and flame. All cremations are performed individually. During the cremation process, it may be necessary to open the cremation chamber and reposition the remains of the Decedent in order to facilitate a complete and thorough cremation. Through the use of suitable fuel, the incineration of the container and 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 non-human material) as the temperature is not sufficient to consume them. Due to the nature of the cremation process any personal possessions or valuable materials, such as dental, gold, or jewelry (as well as any body prosthesis or dental bridgework) that are left with the Decedent and not removed from the casket or container prior to the cremation may be destroyed or if not destroyed, will be disposed of by the Crematory. The Authorizing Agent understands that arrangements must be made with the Funeral Home to remove any such possessions or valuables prior to the time that the remains of the Decedent are cremated. Following a cooling period, the cremated remains, which will normally weigh several pounds in the case of an average size adult, are then swept or raked from the cremation chamber. Although the operator will take reasonable efforts to remove all of the cremated remains from the cremation chamber, it is impossible to remove all of them, as some dust and other residue from the process will be left behind. In addition, while every effort will be made to avoid commingling, inadvertent and incidental commingling of minute particles of cremated remains from the residues of previous cremations is a possibility, and the Authorizing Agent understands and accepts this fact. After the cremated remains are removed from the cremation chamber, all non-combustible material (insofar as possible) such as dental bridgework and hinges, latches, and nails from the container will be separated and removed from the human bone fragments by visible or magnetic selection. The Crematory is authorized to dispose of these materials with similar materials from other cremations in a non-recoverable manner, so that only human bone fragments will remain. When the cremated remains are removed from the cremation chamber, the skeletal remains will often contain recognizable bone fragments. Unless otherwise specified, after the bone fragments have been separated from the other material, they will be mechanically pulverized. These granulated particles of unidentifiable dimensions, which are virtually unrecognizable as human remains, will then be placed into a designated container.
Authorization to Cremate and Pulvarize	As Legally Authorized Person, I have read and understand the description of the cremation process contained above and authorize the cremation, processing and pulverization of the remains of the Decedent.
Final Disposition
HTML Block	Following the cremation, the Legally Authorized Person directs the Funeral Home to undertake the actions set forth below to arrange the final disposition of the cremated remains of the Decedent. If the cremated remains are shipped at any time, the Legally Authorized Person directs that the crematory or Funeral Home utilize registered U.S. Mail with a return receipt or shipping service that uses an internal system for tracking the location of the cremated remains during shipment and requires a signed receipt of the person taking delivery of the cremated remains. You will select your Disposition method when purchasing your Cremation Package.
Please sign that you have read the Statute above.
Cremation Process	Cremation Process, Qty: 1, Price: $795.00
Select Your Urn	Wooden Urn: $150 ($150.00)
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Add Engraving? ($50)	No
Pickup, Delivery or unwitnessed scattering at sea	Pickup at Fort Pierce Location
Cash Advance Items	Cash Advance items are monies escrowed in your arrangement for payment to outside entities or providers for the completion of your arrangements. Examples of cash advance items are death certificates from the office of vital statistics and the registrar, medical examiner's cremation charge. Any associated fees will automatically be added to your package. If your county is not listed, please contact us to see if we can arrange for transportation of your loved one from that county to our local facility.
HTML Block	It is a state requirement for the medical examiner of the district to review the cause of death and give an approval number prior to the cremation taking place.
Options
Death Certificates W/ Cause	0
Death Certificates - Without Cause	Death Certificates - Without Cause, Qty: 1, Price: $14.00
Death Certificates W/O Cause	14
ME Call	No
Add ID Viewing $225	No
Starmark Container Upgrade $195	No
Decline ID Viewing	ID Viewing Declined
Death Occured	Saint Lucie
Mileage Fee	Mileage Fee, Qty: 1, Price: $0.00
HTML Block	Statement of Funeral Goods & Services Selected 1. Services Including Merchandise & Equipment: Simple Cremation Package Itemized: $1,150.00 Pkg. Discount: ($680.00) Pkg. Price: $795.00 This Package includes: Professional administration fee Local removal of remains/refrigeration Cremation process Cremation container (Fiberboard) Temp Urn Mailing fee 2. Additional Product items: [gravityforms action="conditional" merge_tag="No" condition="isnot" value="No"] Add ID Viewing $0 Medical Examiner + ID Viewing $50 [/gravityforms] [gravityforms action="conditional" merge_tag="No" condition="is" value="Yes"] Cremation Container Upgrade: $0 [/gravityforms] Urn Selection Wooden Urn: $150\|150 [gravityforms action="conditional" merge_tag="No" condition="is" value="Yes"] Engraving: $0 ( ) [/gravityforms] [gravityforms action="conditional" merge_tag="Pickup at Fort Pierce Location" condition="contains" value="scattering"] Unwitnessed scattering at sea: $50 [/gravityforms] 3. Items involving cash advances: Death Certificate & Cremation Authorization form [gravityforms action="conditional" merge_tag="" condition="is" value="1"] : [/gravityforms] [gravityforms action="conditional" merge_tag="0" condition="isnot" value="0"] Death Certificates - With Cause @ $14.00 Each ($0) [/gravityforms] [gravityforms action="conditional" merge_tag="14" condition="isnot" value="0"] Death Certificates - With Cause 1 @ $14.00 Each ($14) [/gravityforms] Charges are only for items used. If the type of funeral service selected required extra items we will explain the reason in writing below. If you selected a funeral which required embalming, such as a funeral with viewing, you will have to pay for embalming. You do not have to pay for embalming you did not approve if you selected arrangements such as direct cremation or immediate burial. If we charged for embalming we will explain why on page one.
Total	$959.00
	FDIC, B. Quinn Haisley GENERAL PRICE LIST The goods and services shown below are those we can provide to our customers. These items are shown itemized and are packaged for the consumer at discounts as represented in our line by line itemization for each package represented below. However, any funeral package you select will include a charge for our basic services. 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 of Funeral Goods and Services you selected. PROFESSIONAL SERVICES Itemized as follows: A. PROFESSIONAL SERVICES OF LICENSED FUNERAL DIRECTOR: $300.00 EDRS filing of the death with state, includes permitting and LFD coordination or approvals and endorsements required for cremation. B. REFRIGERATION: $180.00 This charge includes the sheltering and the refrigeration of remains in selected container prior to cremation process. C. REMOVAL: $255.00 Local transportation of remains from the place of death to our facilities (within 25 miles loaded). Transportation Fees outside of local accessed at $2.00 per loaded mile. D. CREMATION: $340.00 Includes the complete process of calcification of remains, pulverization, processing and placement in URN selected. E. IDENTIFICATION VIEW & PREPARATION OF THE BODY: $225.00 Includes limited cosmetology, placement of the deceased in the container selected, necessary sanitary cleansing & care facilitated appointed time and place for viewing. F. SHIPPING AND/OR HANDLING: $125.00 MERCHANDISE CREMATION CONTAINERS A. STARMARK CREMATION CONTAINER: $195.00 B. ALTERNATIVE CREMATION CONTAINER: $120.00 URNS A. TEMPORARY CONTAINER: Included B. WOODEN: $195.00 C. PEWTER FINISH: $325.00 D. ENGRAVING OF URN: $50.00
HTML Block	Download and Print General Price List
Consent	By checking this box, I affirm that I have been provided with a copy of the General Price List to print.
Type Signature	Thomas Garvey
Date	11/10/2022
Signature
Credit Card Disclaimer:	Please note that using a deceased persons credit card is illegal if you are NOT a joint account holder. An authorized signer/user does not qualify. If you proceed using a deceased persons card you will be committing fraud.
Credit Card	Visa XXXXXXXXXXXX8224

The Legally Authorized Person represents that the relationship between the Legally Authorized Person and the Decedent is as follows:

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