Loading
Form preview
  • US Legal Forms
  • Other Templates
  • More Forms
  • More Multi-State Forms
  • Pa Pa 118 2016

Get Pa Pa 118 2016-2026

IENT NO. REQUEST FOR BURIAL AND/OR CREMATION PAYMENT: RELATIONSHIP TO DECEASED: I request the Department of Human Services to pay the burial and/or cremation expenses of: I am a Representative of a fraternal society (deceased was a member) or of a charitable or religious organization: RELATIVE TO BE FILLED IN BY PERSON MAKING REQUEST State Relationship (Give Name of Organization) FRIEND If this block is checked, this form must be accompanied by an unfit certificate from the Anatom.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the PA PA 118 online

The PA PA 118 form is a crucial document for requesting burial and cremation payments from the Department of Human Services. This guide provides detailed, step-by-step instructions to help users accurately complete the form online, ensuring a smooth application process.

Follow the steps to complete the PA PA 118 online effectively.

  1. Click ‘Get Form’ button to obtain the PA PA 118 and access it in your editor.
  2. Begin by filling in the county-district, record number/line number, and social security number related to the deceased. This identification is essential for processing the request.
  3. Provide the name of the deceased, date of death, date of request, and their age at the time of death. Ensure accuracy in these details, as they are critical for the application.
  4. Complete the address field for the deceased, which helps in locating relevant records.
  5. Indicate the relationship to the deceased: as a representative of an organization, relative, friend, or other. If applicable, attach the required unfit certificate if the form is submitted by a friend.
  6. List any payments you are able to contribute towards the burial or cremation expenses in the designated field, and document payments made by others as required.
  7. Detail the assets available in the deceased's estate, including insurance, savings, and property. It's vital to provide accurate amounts and descriptions.
  8. Provide your signature certifying the accuracy of the information provided, along with the date signed. This is crucial to validate your request.
  9. If applicable, complete the certification section for the executive director, including any resources that may reduce the DHS payment.
  10. Complete the invoice section as a funeral director, including specific burial or cremation charges, and ensure the certification by the funeral director is signed.
  11. Once all fields are filled accurately, you can save changes, download, print, or share the form as needed.

Take the next step in the process by completing your PA PA 118 online today.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

pa-118f.pdf - Wisconsin Department of Revenue
Submit form to local Clerk for computation of municipal permit fee. CLERK: Complete...
Learn more
Chapter 118 - REDUCTIONS OF MAJOR WATER USE IN A...
This chapter cited in 4 Pa. Code § 120.13 (relating to additional water conservation and...
Learn more
The RISC-V Instruction Set Manual, Volume I: User...
by A Waterman · 2016 · Cited by 143 — The conditional branches were designed to...
Learn more

Related links form

Building Department Town Of Riverhead Ny Clerk Of Court Electronic Filing Registration Form. - Cuyahoga ... - Coc Cuyahogacounty TETFUND CONFERENCE ATTENDANCE Nomination - Fuotuoke Edu Amateur Radio General Message Form (213)

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Get PA PA 118
Get form
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Other Templates
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Form Packages
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
Form Categories
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Other Templates
Customer Service
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
Legal Guides
  • Real Estate Handbook
  • All Guides
Prepared for you
  • Notarize
  • Incorporation services
Our Customers
  • For Consumers
  • For Small Business
  • For Attorneys
Our Sites
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 17 Station Street, Suite 303, Brookline, MA 02445
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program