Required fields are marked with asterisks (*)

Interment Authorization Form

Please complete all required answers. Also ensure your fillable PDF application has been uploaded. Only one application per person buried is required.

Full Name (Representative of the deceased)

Phone #

Email Address

Urn Interment Map

*By using the diagrams below, please select the Type of Plot and Space you wish to have your urn interred in.

Cemetery Plots diagram

Please select the type of burial being requested

Human remains casket burial

In-ground cremated remains

Niche cremated remains

Please select the date range you wish to have your burial

Nov. 1 - Apr. 30

May 1 - Oct. 31

Will the burial be taking place on a Saturday, Sunday or Holiday?

Yes

Is this a late notice burial (within 24 hrs of notifying the City)?

Yes

To complete the Interment Authorization Form, click here. (Fillable PDF).

Please upload completed copies of your completed Interment Authorization form

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Please upload completed copies of a burial permit/Certificate of Cremation/Statement or Certificate of Death.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Protection of Privacy Act, Sec. 4 (c), which regulates the collection, use, and disclosure of personal information.

If you have any questions or concerns, please contact the ATIA Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.