Private Pet Cremation:

Date: _____________________

Pet Owner: ___________________

Address:______________________

City:__________________________

Phone:________________________

Pet Name/Breed:____________________________

Weight:______________________________________

Does your Pet have any type of Implant.   Yes or No

If yes What Type:______________________

Cremation Prices:

            1-10 Pounds                                        $115

            11-25 Pounds                                      $135

            25-50 Pounds                                      $165

            51-75 Pounds                                      $190

            76-100 Pounds                                    $205

            101-125 Pounds                                  $250

            126 Pounds +                                      $250 +$1 per additional pound up to

Your Pets Cremation Price:_____________

Memorial URN Price:__________________

Pick Up/Delivery Fee:__$100.00________________

Paperwork and Processing:____$50.00________________

Total:________________________

I,The undersigned,understand that I use pick up my pet’s cremains no later than 30 days form the date notified by phone. Should I fail to do so, I Authorize Dolfi Funeral Home to dispose of the cremains as they see fit.

Pet Owners Signature:_______________________

Payment Method:  Cash, Credit, Check