FORM - Notification of Death FOR INTERNATIONAL TEAMS ONLY

OKLAHOMA CONFERENCE OF THE UNITED METHODIST CHURCH

CONNECTIONAL MINISTRIES FOR MISSION
NOTIFICATION OF DEATH

FOR INTERNATIONAL TEAMS ONLY
Name LEGAL NAME AS IT APPEARS ON THE PASSPORT

First NameLast Name
Country your passport is issued.
Most of these will be USA
What is your passport number?
What is the expiration date on your passport
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
In the event of my death, should my death occur outside the United States, a family member or a Bishop of The United Methodist Church or a representative of the US State Department/US Embassy is to be instructed by the following:
1. Immediately contact the following:
My family or other:
Work Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
2. My wishes are as follows: (choose option A or option B)
"A". My body is to be cremated if possible, prior to being shipped back t the United States. Where possible, arrangements for the cremation are to be made in consultation with the United States Embassy of the nation where the death occurred
My remains are then to be shipped to:
"B" I do not wish to have my body cremated. My body is to be shipped to the US, in keeping with the requirements of the nation where the death occured to (funeral home)
Name of funeral home
All my valuables, money, and personal possessions are to be kept in the control of the represtative o th United States Embassy and shipped to:
In the event of death, all of the above instructions are to be followed in consultation with the above-named family member if that family member's physical condition and location make such consultation possible. Further, all valuables, money and personal possessions are to be placed in the possession and control of the above -named family member.
Signature of Missioner/Team Member/Participant (If under 18, must be signed by parent or guardian

Clear
Date signed

MonthDayYear
Date
THIS INSTRUMENT WAS SIGNED ON THE ABOVE DATE BY THE ABOVE PERSON IN THE PRESENCEOF EACH OF US, THE UNDERSIGNED WITNESSES, AS A FREE AND VOLUNTARY ACT AND DEED FOR THE PURPOSES THEREIN EXPRESSED.
Signature of 1st witness

Clear
Name of 1st Witness
Signature of 2st witness

Clear
Name of 2st Witness
Should be Empty:

OKLAHOMA CONFERENCE OF THE UNITED METHODIST CHURCH

NOTIFICATION OF DEATH

In the event of my death, should my death occur outside the United States, a family member or a Bishop of The United Methodist Church or a representative of the US State Department/US Embassy is to be instructed by the following:

1. Immediately contact the following:

2. My wishes are as follows: (choose option A or option B)

THIS INSTRUMENT WAS SIGNED ON THE ABOVE DATE BY THE ABOVE PERSON IN THE PRESENCEOF EACH OF US, THE UNDERSIGNED WITNESSES, AS A FREE AND VOLUNTARY ACT AND DEED FOR THE PURPOSES THEREIN EXPRESSED.