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Required Information:

A copy of your passport (page that includes your photo and the opposing page).
Spouses applying together provide 2 copies of marriage certificate.
Deliver to the Association's mail box 41B at Solutions in Mercado Sano.

Please complete carefully and clearly. The following data and documents requested are essential for issuance of a Mexican Death Certificate and for US citizens, the information will also be needed for completion of the Report of Death Abroad at the US consulate.

First Name: *
Middle Name: *
Last Name: *
Gender:
Date of Birth: *
Place of Birth:
Nationality:

US citizens only:
Social Security Number:
Do you receive Federal Benefits?:
YES
NO

Type of Benefit:
Adress in México:
Street & Number:
Colonia:
City:
State:
Zip Code:
Cell Phone Number:
Email: *
Local Mail Service:
If yes, Name of Provider:
Location of Provider:
Yes
No

Addres in México
Street & Number:
Colonia:
Mothers Full name to include Maiden Name:
Fathers Name:
:
Alive
Deceased

Spouses Full name to include maiden name:
Education:
Name of Doctor in San Miguel:
Best Number for Contacting Doctor
Cell:
Office:
WhatsApp:
Upon my death please notify the following people 
(provide for notifying up to 4 people):
Name:
Relationship:
Phone: *
Service Requested:
Cremation - includes urn and delivery of cremains as instructed in SMA
Cremation & Niche - includes urn, niche
Burial in Crypt - includes casket, crypt space, interment and inscribed plaque
Burial in Grave - includes casket, plot, interment, and inscribed headstone

:
I understand that all services include one (1) Mexican Death Certificate

Deliver my cremains to:
Name:
Address in SMA:
Phone:
Email:
Ship my cremains to as instructed at an additional expense which my estate will pay:
Name:
Address:
City:
State/Providence:
Postal Code:
Country:
:
I understand that I may change these instruction at any time with appropriate adjustment of account balance

:
I understand that if I die of COVID19 my body is to be cremated by Mexican law regardless of the service I have selected.

You may resign your membership at any time and for any reason. Please contact the executive secretary or the treasurer of the association at 24hourassociation@gmail.com and submit a written request for refund.
Payment Options

Cash     Contact Executive Secretary
Credit Card
PayPal    these 2 options are in process. Will notify you when it is set-up
Mexican Check

Make Check Payable to 24 Horas de San Miguel de Allende, A.C.
Check must be completed in same color ink