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Bare Cremation - WA Forms

This form encompasses all of the required documentation to arrange and undertake a cremation. Please fill out the form to the best of your ability and submit. If you have any questions at all, please don't hesitate to contact our team 24/7 on 1800 071 176
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    • Saudi Arabia
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  • 30
    The nearest surviving relative of a deceased person is the first person who is available from the following persons in the order of priority listed — (a) a person who, immediately before the death, was living as — (i) the spouse of the deceased; or (ii) a de facto partner of the deceased and who is at least 18 years of age; (b) a son or daughter of the deceased who is at least 18 years of age; (c) a parent of the deceased; (d) a brother or sister of the deceased who is at least 18 years of age.
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  • 31
    Husband/Wife, Brother/Sister, Son/Daughter etc
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  • 32
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  • 33
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  • 34
    Please Select
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  • 35
    Please select the most valid answer below
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  • 36
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  • 37
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  • 38
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  • 39
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  • 40
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  • 41
    Hidden field to parse marriage status as text
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  • 42
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  • 43
    Please list previous marriages. Please list spouse's surnames at the time of marriage. If never previously married, please skip this question.
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  • 44
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  • 45
    List names in order of their birth (from oldest to youngest). If the child is deceased enter ‘D’ in age column. If more than seven children, please email service@bare.com.au with their details. Include legally adopted children. If no children write ‘None’.
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  • 46
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  • 47
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  • 48
    Why do you believe that an examination of the deceased remains may be desirable?
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  • 49
    If these do not apply, just click "Next"
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  • 50
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  • 51
    Please Select
    • Please Select
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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  • 52
    Hidden field - Pre Populated
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  • 53
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  • 54
    You have answered the previous question stating that the deceased left instructions. Please provide details of those instructions.
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  • 55
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  • 56
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  • 57
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  • 58
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  • 59
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  • 60

    Important. Please Read

    The Final step is to sign the required paperwork.

    By signing you state that you understand and agree to the signing of the following documents:

    1. Form 6 Application for Cremation: In this form you, as the nearest surviving relative are applying to have your loved one cremated at a Metropolitan Cemeteries Board Crematorium.

    2. 6th Schedule Certificate Dispensing with identification: In this form you are agreeing to not carrying out a formal identification of your loved one, but that as your Funeral Directors, Bare will certify your loved one is placed in a coffin bearing the correct name.

    3. 4th Schedule Instruction for ashes: In this form you are nominating to have a direct cremation at a Metropolitan Cemeteries Board Crematorium for your loved one and your instructions for the ashes are advised.

    I also sign that I am aware of, and consent to, the use of Bellrae Mortuary Services as part of the this service for Transfer and Mortuary Services.

    Before signing you can see the actual forms by clicking on the “preview PDF” box at the bottom of this page.

    Once you are satisfied you understand what your signature will be attached to please move onto the next screen.

    By moving on to the signing page and signing, you are agreeing to the above.

     
     
     
     
     
     
     
     
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  • 61
    The final step is to sign the required paperwork. If you have a touch screen computer or tablet, you can do this with your finger on the screen. If you do not have a touch screen, then you can sign a piece of paper and upload or photograph your signature for us
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  • 62
    Only use this if you have a touch screen device and can sign with your finger. If you don't, then please press "Previous" below and choose to upload your signature. The person signing must be the Next of Kin who is completing these online questions, and who is the named applicant. Your signature will need to match the signature as it appears on your drivers licence or other Photo ID. THIS WILL BE CHECKED WHEN YOU COLLECT YOUR LOVED ONES ASHES.
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  • 63
    If you require assistance, please call us on 1800 071 176
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  • 64
    If you require assistance, please call us on 1800 071 176
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  • 65
    If you require assistance, please call us on 1800 071 176
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    Max. file size: 10.6MB
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  • 66
    We are required to sight your ID. Please have your drivers license or other photo ID ready (must show photo and signature), and then choose the correct option below.
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  • 67
    Drag and drop files here
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    Max. file size: 10.6MB
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  • 68
    Hold the ID up to the camera and ensure there is good lighting and focus
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  • 69
    Please enter todays date in the following format 21 July 2021
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  • 70
    /
    Pick a Date
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  • 71
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  • 72
    If payment will come from the deceased estate, please provide the executor name.
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  • 73
    If payment will come from the deceased estate, please provide the executor phone number.
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  • 74
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  • 75
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  • 76
    If you select YES, you will need to have the deceased Centrelink CRN number handy
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  • 77

    You have now completed all forms required. Please select "Review" and check all answers prior to submitting.

    Once submitted, the forms will be sent directly to your arranger.

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Bare Cremation - WA Forms
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