AUTHORIZATION LETTER

I (full name) ____________________________________________________________
gotra________________________ Relation(Eg. Son of)_________________________
(deceased's name)_______________________________ gotra __________________
hereby declare that Shri / Smt. (deceased's name)____________________________
has expired at time________:______:_________ on date________/______/________
at place_________________________ . The crimination has been performed by us at
time_________:___________:___________ on date________/________/_________at
place______________________________________.

I, hereby, authorize Kashi Moksha Inc.., Varanasi (INDIA) to perform Asthi
Visarjan rituals at ________________________ (place) on my behalf.

I also declare that the information provided by me to Kashi Moksha Inc, is
true to the best of my knowledge.

Date :
Place :

Signature