Immediately After Death
Immediately after someone dies, several things need to happen. First, a medical professional will need to fill out the Pronouncement of Death form. Then arrangements will have to be made to move the body from its place of death. Finally, a death registration form must be completed and filed with the county in which the person died. And, if the person dies out of state (away from their home) or out of the country there are additional steps that will need to be taken.

Pronouncement of death and transportation
Registration of the death and death certificates
Death out of state
Death out of the country
Transporting ashes
Pronouncement of death and transportation

Arrangements will need to be made to transport the body to a mortuary, crematory or the coroner’s office unless there is going to be a home burial service. However, before the body can be moved anywhere, a medical professional will need to complete a Pronouncement of Death form. The date and time on the form will become the official time of death.

If it appears that the death was not from natural causes, the Coroner’s office will be contacted to see if an autopsy needs to be done.

If the death occurs in a hospital:

Someone at the hospital will complete the Prouncement of Death form.

Federal law requires the person completing the Pronouncement of Death form to notify the hospital’s organ procurement staff. The organ procurement staff will talk with the family about the opportunity to donate organs or tissue.
The hospital or a family member will call the funeral home and make arrangements for the body to be picked up and transferred to a funeral provider or other designated facility. If the hospital has a morgue, they may transfer the body there while waiting for transportation.
If the death occurs at home:

Someone will have to call 911 and request that a person be sent to the house to complete the Pronouncement of Death form. If hospice was involved, they can complete the form.
If the death is a result of an accident:

Pronouncement of death may be at the scene of the accident or the body may be taken to a hospital or a coroner’s office, where the pronouncement will occur.
If the death is in a nursing home:

Medical professionals there can also complete the form.
The nursing staff there will arrange for an immediate pickup of the body since they don’t have a morgue in which to store the body. In fact, most nursing homes, as part of their admitting practice, require the identification of a funeral establishment in case of death. Then the nursing home can make arrangements to transfer the body to that funeral home if they can’t immediately locate the next of kin.
If arrangements have been made to donate the body to medical science:

The next of kin or designated agent should notify the medical institution with which the deceased made prior arrangements to ask what they want done with the body. A contact name and phone number should be available in the contract provided by the medical institution. FYI, the contract should specify whether the institution or the estate will be for transportation of the body.
If death is unexpected, traumatic or suspicious, or the cause of death cannot be documented on the death certificate:

The body may need to be taken to the coroner’s office where an autopsy will be performed to determine the cause. Different county and state laws determine whether the coroner is required to examine the body.

If an autopsy is to be performed, the state in which the person died may require a family member to sign an authorization form. Some counties have funds available for autopsy and body transportation; others may charge for these services.

Once the autopsy has been completed, the body will be released.

Registration of the death and death certificates

State laws require the funeral provider, coroner or person in charge of a home funeral to complete the following:

Death Registration form – This form collects two types of information about the deceased. The first is demographic information and is usually provided by the deceased’s family. The second type identifies the cause of death; that information is provided by a physician or coroner.
Burial Permit form – identifies the type of disposition that has been chosen and also states where the deceased will be buried or where and how the ashes will be scattered.
Both of these forms must be submitted to the County Recorder in the county in which the deceased died for review and approval. The body cannot be disposed of without them having been signed by the County Recorder. After disposal, the entity responsible for that disposal must sign the Burial Permit form and return it to the County Recorder.

FYI, the county office processing death registration forms is called different names in different counties and states including the Department of Health, the Department of Vital Statistics or the Recorder’s Office.

Once the County Recorder has certified the death registration form as complete and accurate, they can provide:

A Certified Death Abstract (commonly called a Death Certificate) printed on official paper. This certified death abstract is the document most organizations require as proof of the death. For example, if the deceased had a life insurance policy, the company will not provide benefits without this proof of death.

The executor of the estate must pay a fee for every copy of this form that is needed; it varies by state but usually ranges between $10 and $15 each. An original certified death abstract includes the signature of the County Recorder as well as the county seal. Some organizations processing death claims will accept a photocopy of the death certificate but many require an original. On average, ten certified death abstracts are required to settle an estate.

The certified copy of the death registration form is called a Certified Death Abstract because the information on it is an abstract of the data actually collected on your death registration form. The abstract only lists the name of the deceased and his or her date of birth. The death registration form also collects the cause and place of death information, which is provided by a physician or a coroner.

Most mortuaries or crematories can help the designated agent or executor to obtain certified original death abstracts by requesting them when they submit the death registration form to the county in which the deceased died. They will pay the certified death registration fees to the county and then bill these costs as part of the funeral. If the funeral director does not do this, or if the funeral agent or executor finds that they need additional originals, they will need to visit the county recorder and request them. Because certified death abstracts are often used in identify theft, some states now require any later requests for death certificates to be submitted on notarized forms.

A copy of the Death Registration form is kept on file in the County Recorder’s office where the death occurred for a period of time which varies by state. The County Recorder then forwards the approved Death Registration form to the State Department of Vital Statistics where the signed death registration will be stored as a permanent record.

The designated agent, executor or next of kin should check the death registration form carefully for any errors. If the date of death is entered incorrectly, the printed death certificate will show the wrong date of death, which could be a problem in closing out accounts, settling insurance claims, etc.

Death out of state

If the deceased died out of state and desires a traditional burial service, their designated agent or a family member will probably need to arrange to transport their body back home. This will require the coordination of a funeral home in each city. Most funeral homes have relationships with world-wide agencies that specialize in shipping bodies home. If a body is shipped on a common carrier, it must be embalmed prior to shipping or sealed in an airtight casket or transportation container.

The cost for shipping human remains via air within the United States ranges from $275 to $1,500 plus applicable tax. For example, to ship a body from California to New York costs $525; from Florida to Massachusetts costs $305.
Source: Delta Cares – a division of Delta Air Lines – published rates 6/09

Two other options can also be considered:

A funeral and burial in the city in which the death occurred.
Cremation in the city of death and then shipment of the cremains.
If the deceased purchased a pre-need funeral policy, it may be transferable to the city in which the deceased actually died. It depends on the actual policy and the state in which the deceased officially resided. Whoever is handling funeral arrangements should contact the funeral home with whom the deceased signed a contract to find out what should or can be done.

Involving the funeral home that will be used for the funeral is usually a good first step. They can help to arrange transportation, etc.

Death out of the country

If the deceased died outside of the United States, the designated agent or a relative should contact the United States Consulate in the country in which the death occurred and they should be asked for help in making the arrangements for the return of the body or for its disposition in the foreign city. See http://usembassy.state.gov/ for a list of the consulate addresses and phone numbers.

The U.S. Department of State should also be contacted for further information and help.

Certain documents are required by U.S. and foreign countries’ laws before remains can be sent from one country to another and those documents may vary depending on the circumstances of the death.

A U.S. consular mortuary certificate-prepared by the U.S. consular office, and will be required if the body is being returned to the United States. This document, written in English, contains necessary information including the cause of the death. Generally, if the remains have been embalmed, the documentation which accompanies the consular mortuary certificate will satisfy U.S. public health requirements.

A foreign death certificate provided by the U.S. consular mortuary (if available).

The affidavit of the foreign funeral director – This document attests that the casket contains only the deceased’s body and clothing, plus packing materials.

The body transmit permit – It will accompany the remains to the United States and is issued by local health authorities at the port of embarcation.

A bill of lading – If the remains are not accompanied by a passenger, a bill of lading must be issued by the airline carrier to cover the body’s transportation.

Report of Death of an American Citizen Abroad- Prepared by the Consular Officer, this report includes the essential facts concerning the death, planned disposition of the remains and custody of the deceased’s personal effects. It may also serve as a death certificate in the United States for probate, inheritance and other purposes. The next of kin will also find this report helpful in dealing with insurance companies, Social Security Administration, Department of Veterans Affairs, financial institutions such as banks and credit card companies, or any other situation in which proof of death is needed.

If the remains have not been embalmed, the U.S. consular officer should alert U.S. Customs and the U.S. Public Health Service at point of entry in advance, faxing copies of the consular mortuary certificate, local death certificate (if available), affidavit of the foreign funeral director and a formal statement from competent foreign authorities stating that the individual did not die from a communicable disease. Otherwise, the deceased’s family may have a problem getting the body back into the United States.

Once the body is received by a local funeral provider in the United States, that provider will complete the required death registration form and cremation or burial permit forms.

If the deceased is a U.S. citizen and when he or she dies abroad there is no legal representative present in the country, the consular office usually notifies the deceased’s next of kin by official telegram relayed through the Department of State in Washington, D.C. The U.S. consular office will then receive instructions from the deceased’s legal representative and will arrange for disposition of the remains. The consul can also act as provisional conservator of the deceased’s personal effects, such as jewelry and clothing and will pay local debts such as a hospital bill, from funds available in the deceased’s estate of from funds received from the legal representation

Transporting Ashes

If the body is cremated in an out of state or out of country location and the ashes are being brought home or taken to another location to be scattered, there are Department of Transportation (DOT) regulations that must be followed.

If the urn is being transported as carry-on luggage, it MUST pass through the x-ray machine and be screened. Whoever is carrying the urn or other container needs to be sure it is made of a material that can be successfully x-rayed, such as wood, plastic or a non-lead lined ceramic. If the container is made of a material that generates an opaque image and prevents the security scanner from clearly seeing what’s inside, the container will NOT be allowed through the security checkpoint. And under no circumstances will a screener open the container or urn, even if the person carrying it requests this action.