Form CIV-715 "Affidavit in Support of Petition for Order Authorizing Disposition of Unclaimed Body (Under as 12.65.100)" - Alaska

What Is Form CIV-715?

This is a legal form that was released by the Alaska Court System - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the Alaska Court System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form CIV-715 by clicking the link below or browse more documents and templates provided by the Alaska Court System.

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Download Form CIV-715 "Affidavit in Support of Petition for Order Authorizing Disposition of Unclaimed Body (Under as 12.65.100)" - Alaska

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IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA
AT
In the Matter of:
)
)
)
)
CASE NO.
)
Deceased
)
AFFIDAVIT IN SUPPORT OF
)
PETITION FOR ORDER AUTHORIZING
DISPOSITION OF UNCLAIMED BODY
(UNDER AS 12.65.100)
I, the undersigned, swear or affirm under penalty of perjury that the following is true to the best
of my knowledge and belief following diligent inquiry:
1.
I became aware of, and am providing, the following information in my capacity as:
(funeral home employee, law enforcement investigator, landlord, guardian, health facility employee, etc.)
2.
The deceased person named above died at or near
,
Alaska, on or about
, under the following circumstances:
3.
Other information known about deceased:
Last known address
Last employer
Employer’s address
Other
4.
No person has appeared to claim the body for burial.
a. The following relatives or interested persons were located, but are unwilling or
unable to claim the body:
Name
Relationship
Address/Phone
b. The following relatives or interested persons were identified but cannot be
located:
Name
Describe Attempts to Locate
Page 1 of 3
CIV-715 (2/18)(cs)
AFFIDAVIT IN SUPPORT OF PETITION RE UNCLAIMED BODY
AS 12.65.100 & 110
IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA
AT
In the Matter of:
)
)
)
)
CASE NO.
)
Deceased
)
AFFIDAVIT IN SUPPORT OF
)
PETITION FOR ORDER AUTHORIZING
DISPOSITION OF UNCLAIMED BODY
(UNDER AS 12.65.100)
I, the undersigned, swear or affirm under penalty of perjury that the following is true to the best
of my knowledge and belief following diligent inquiry:
1.
I became aware of, and am providing, the following information in my capacity as:
(funeral home employee, law enforcement investigator, landlord, guardian, health facility employee, etc.)
2.
The deceased person named above died at or near
,
Alaska, on or about
, under the following circumstances:
3.
Other information known about deceased:
Last known address
Last employer
Employer’s address
Other
4.
No person has appeared to claim the body for burial.
a. The following relatives or interested persons were located, but are unwilling or
unable to claim the body:
Name
Relationship
Address/Phone
b. The following relatives or interested persons were identified but cannot be
located:
Name
Describe Attempts to Locate
Page 1 of 3
CIV-715 (2/18)(cs)
AFFIDAVIT IN SUPPORT OF PETITION RE UNCLAIMED BODY
AS 12.65.100 & 110
c. The following efforts yielded no names of relatives or interested persons:
contacted acquaintances, neighbors, etc.
Person Contacted
Relationship
to Deceased
Address/Phone
searched the following records (such as
vital records, employment, PFD records, military records, court records):
examined the personal effects and other
property of the decedent located at:
for the purpose of locating information about relatives.
Other:
5.
I have no information regarding whether the deceased left information or
instructions regarding funeral or disposition.
The deceased left information or instructions regarding funeral or disposition
wishes as follows (when were instructions left, what were the instructions):
6.
No provision has been made for the body under AS 13.50 (the Uniform Anatomical Gift
Act). I made the following efforts to confirm this:
examined the person’s personal effects
and
and found no organ donor card.
(billfold/purse/driver’s license/other
located the person’s will/living will and
determined that no such gift is made in it.
Other efforts to determine whether a gift has been made:
Page 2 of 3
CIV-715 (2/18)(cs)
AFFIDAVIT IN SUPPORT OF PETITION RE UNCLAIMED BODY
AS 12.65.100 & 110
7.
Property.
I am not aware of any money or other property belonging to the deceased.
I am aware of the following money or property of the deceased:
personal effects located at
other property located at
8.
Other information relevant to the petition:
Date
Signature of Person Making this Affidavit
Type or Print Name and Title
State Office/ Dept./Funeral Home/Other Ofc.
Address
Telephone Number
Fax Number
Subscribed and sworn to or affirmed before me at
,
Alaska, on
.
(date)
(SEAL)
Clerk of Court, Notary Public, or other
person authorized to administer oaths.
My commission expires
Page 3 of 3
CIV-715 (2/18)(cs)
AFFIDAVIT IN SUPPORT OF PETITION RE UNCLAIMED BODY
AS 12.65.100 & 110
Page of 3