Oregon Disposition Appointment Form

Appoint A Person To Make Decisions Concerning Disposition of Remains

This form gives individuals an opportunity to decide and legally state who will be responsible for their body after death. It must be completed BEFORE the death occurs. Download the PDF form.

APPOINTMENT OF PERSON TO MAKE DECISIONS
CONCERNING DISPOSITION OF REMAINS

I, ________________________________, appoint_______________________________, whose address
is _____________________________________________________ and whose telephone number is
(_____)______________________, as the person to make all decisions regarding the disposition of my
remains upon my death for my burial or cremation. In the event ___________________________ is unable to
act, I appoint ____________________________, whose address is
____________________________________________ and whose telephone number is
(_____)_____________________, as my alternate person to make all decisions regarding the disposition of
my remains upon my death for my burial or cremation.

It is my intent that this Appointment of Person to Make Decisions Concerning Disposition of Remains act
as and be accepted as the written authorization presently required by ORS 97.130 (or its corresponding future
provisions) or any other provision of Oregon Law, authorizing me to name a person to have authority to
dispose of my remains.

DATED this _______ day of____________________,__________.
_________________________________________________
(Signature)

DECLARATION OF WITNESSES

We declare that _________________________________ is personally known to us, that he/she signed this
Appointment of Person to Make Decisions Concerning Disposition of Remains in our presence, that he/she
appeared to be of sound mind and not acting under duress, fraud or undue influence, and that neither of us is
the person so appointed by this document.
Witnessed By:
________________________________________________ Date: _______________________

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