Lloyd Edward Memorial

6677 Rookin St
Houston, TX  77074
phone (346) 446-6675 or (346) 847-8138
www.lloydedwardmemorial.org

 

State of Texas  

County of Harris  

Before Me, the undersigned authority, on this date, personally appeared the undersigned  Affiant who after being duly sworn by me did deposeth and sayeth:  

I, ,

Am the of  

Race:    Sex:   Age:  

 

I HEREBY authorize Lloyd Edward Memorial:  

To Recover the body of the deceased from , and direct  Lloyd Edward Memorial to transport the remains of the deceased to their location at  6677 Rookin St., Houston, TX 77074.  

The undersigned Affiant acknowledges that he/she is the legal next of kin and authorizes the above funeral home to release the decedent and all his or her personal effects in possession. I (We) do agree to indemnify and hold harmless all funeral home parties from any and all loss, costs, actions, or damage which they may suffer as a result of such said release.  


Affiant
Please sign at the bottom part of this document.
Witness
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This Instrument was sworn to and subscribed before me this December 13, 2025

(SEAL} Notary Public in and for Harris County, Texas  

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Signature Certificate
Document name: Lloyd Edward Memorial Authorization Release Form
lock iconUnique Document ID: b1addec93ef11667681b2bf2d7cc79dd518eb8f0
Timestamp Audit
December 11, 2025 7:39 am CSTLloyd Edward Memorial Authorization Release Form Uploaded by Angela Winston - info@lloydedwardmemorial.org IP 150.228.189.235
December 11, 2025 7:44 am CSTKaren Faustino - karen@baynedm.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:45 am CSTAmber Odu - ambi.odu@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:45 am CSTAngela Winston - winston.angela@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:47 am CSTKaren Faustino - karen@baynedm.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:47 am CSTAmber Odu - ambi.odu@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:47 am CSTAngela Winston - winston.angela@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:51 am CSTKaren Faustino - karen@baynedm.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:51 am CSTAmber Odu - ambi.odu@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:51 am CSTAngela Winston - winston.angela@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:56 am CSTKaren Faustino - karen@baynedm.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:56 am CSTAmber Odu - ambi.odu@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
December 11, 2025 7:56 am CSTAngela Winston - winston.angela@gmail.com added by Angela Winston - info@lloydedwardmemorial.org as a CC'd Recipient Ip: 150.228.189.235
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https://www.lloydedwardmemorial.org/
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