Government of Ontario: Ministry of Community Safety and Correctional Services

Office of the Chief Coroner

The Coroners Act – Province of Ontario

Certificate for Shipment of a Body Outside of Ontario

I do certify that I have investigated the death of:

Name
Sex
Age
now lying at (Location of body OR name of funeral home)
in the municipality of in the Province of Ontario, and that there exists no reason for futher examination of the body.

The cause of death is as follows:

While the above represents the cause of death based on the information provided, this does not exclude the possibility that the body may contain communicable diseases. Routine practices (universal precautions) should be used at all times when handling and transporting the body.

Coroner’s Name
Address

Telephone No.

Coroner’s Signature

Date (yyyy/mm/dd)

Note: The completion of this form in no way obviates the requirements of the Vital Statistics Act. The death MUST be registered and a burial permit obtained.

Personal information contained on this form is collected under the authority of the Coroners Act, R.S.O. 1990, C. C.37, as amended. Questions about this collection should be directed to the Chief Coroner, 26 Grenville St., Toronto ON M7A 2G9, Tel.: 416 314-4000 or Toll Free: 1 877 991-9959.