I hereby authorize Deep Commitments to take possession of and make arrangements for, the
disposition of the cremated remains of ______________________________________________
("Deceased") in accordance with and subject to the terms and conditions set forth in this
Authorization; the Company's Rules and Regulations; and any applicable federal, state, provincial
or local laws and
 regulations.

I certify that I have the full legal right and authority to authorize the disposition of the remains of
the Deceased.

I hereby authorize Deep Commitments to make disposition of cremated remains of the Deceased
 at sea in:

I hereby direct Deep Commitments to scatter said cremated remains at sea, in accordance
with State and Federal Law.

Special Instructions:
__________________________________________________________________
__________________________________________________________________
If no specific instructions are provided herein, scattering will be performed by
Deep Commitments, in a timely manner, weather permitting.

"Scattering" consists of the scattering of cremated remains at sea. I understand that once
 the cremated remains of the Deceased are scattered, they are unrecoverable. Unless
otherwise specifically provided for herein, once scattering of cremated remains of the
Deceased has been performed, Deep Commitments will dispose of the container which
contained said cremated remains.

The obligation of Deep Commitments shall be limited to the disposition of the cremated
 remains as directed herein. I agree to release and hold harmless Deep Commitments,
its affiliates and their agents, employees, successors and assigns from any and all loss,
damage, liability or causes of action (including attorney's fee and expenses of litigation)
in connection with the disposition of the cremated remains of the Deceased as authorized
 herein or respect to the identification of said cremated remains as being those of the Deceased.

Date of authorization _______________________________