Office of the Chief Coroner
The Coroners Act – Province of Ontario
Re: , deceased.
To: , deceased.
I (Name) am the Coroner investigating the death(s) of who died on
As a result of information that has been supplied to me, I have reasonable and probable grounds to believe that the following items/things are necessary for the purpose of the investigation: Accordingly, by the authority granted to me under the Coroners Act, I direct you to release the above items to: (Name)
Dated this (day) day of (month) 20 at (location)
Coroner’s Name (Please print) Date Signed (yyyy/mm/dd)
Coroner’s Signature