Professional Documents
Culture Documents
________________ ) S.S.
x- - - - - - - - - - - - - - - - - - - - - - - - //
1. That I am the sister of the late _________________ and represents the family;
2. That my brother died on ________ at around ______ due to _____________;
3. That he was rushed to the hospital in ____________ but was declared dead on
arrival;
4. That upon the consensus of the family members, we decided to forego the autopsy
of his body and release ______________ from whatever liability, if there is any, as a
result of this decision not to perform an autopsy of my brothers remains;
5. As such, I am executing this Waiver to attest to the truth of the foregoing and for
whatever legal purpose it may serve.
________________
ACKNOWLEDGMENT