CONNECTICUT PROBATE COURTS Petition for Award of Custody of the Remains of a Decedent PC- 908 NEW 4/16 RECEIVED: Instructions: 1) An adult person designated to have custody or control of a deceased person222s body in a document executed pursuant to C.G.S. section 45a-318 (a), OR an adult relative entitled to custody and control under C.G.S. section 45a-318 (d), OR the first selectman, chief executive officer or director of health of the town in which the deceased person222s body is held, OR the funeral director or other institution holding the deceased person222s body may use this form to petition for custody, control or disposition of 2)The petition should be filed in the court for the probate district in which the deceased person resided orwas domiciled. 3) Type or pri nt the form in ink. Use Second Sheet, PC - 180, or an additional sheet Probate Court Name District Number In the Matter of Date of Death Hereinafter referred to as the deceased. Residence or Domicile of Deceased (address.) Petitioner (and address.) Person designated by document to have custody and control Town Official Institution holding body Relative of deceased (specify relationship) Other Name and Address of Other Persons Entitled to Notice: Include any person designated by the deceased in advance of death to have custody and control of the decTHE PETITIONER REPRESENTS THAT: The deceased person resided or was domiciled in the probate district as of the date of death. All persons entitled to custody, control and disposition of the deceased person222s body pursAmerican LegalNet, Inc. www.FormsWorkFlow.com CONNECTICUT PROBATE COURTS Petition for Award of Custody of the Remains of a Decedent PC- 908 NEW 4/16 Pers ons entitled to custody or control of the deceased person222s body under to C.G.S. section 45a-318 could not be contacted within 48 hours of the deceased person222s death or discovery of the body or declined to assume custody and control. Explain below: There is no proceeding pending or contemplated under C.G.S. sections 54-102,19a-270 or19a-406 to 19a-408 inclusive, that would preclude consideration of this matter by the court. The decedent was a beneficiary under the state supplement or temporary family assistance program, and the State of Connecticut is obligated to pay funeral and burial expenses under C.G.S. section 17b-84. The decedent had a pre-paid funeral contract or burial insurance. THE PETITIONER REQUESTS THAT: The court enter a decree granting custody and control of the remains of the deceased person to the petitioner pursuant to C.G.S. section 45a-318. The representations made in this petition are made under the penalty of false statement. Signature of Petitioner Title Type or Print Name Date Petition for Award of Custody of the Remains of a Decedent PC-908 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com