How do I submit the Indigent Burial Assistance Application?

The form does not give a submission address or method. It says the funeral home must attempt to contact the family and wait 72 hours before referring the case to the County.

What information does the application ask for?

It asks about the deceased, living relatives, the applicant’s household and income, and the funeral home’s investigation of resources and referral efforts.

Who completes the funeral home section?

The funeral home completes the designated section, which asks about resource investigations, possible benefits, and other information relevant to determining eligibility.

Palo Pinto County, TX · Palo Pinto County

No notary required

Application for Indigent Burial Assistance

This application helps Palo Pinto County determine whether a deceased person and their family qualify for county burial or cremation assistance.

At a glance

Issued by: City of Palo Pinto County · Palo Pinto County, Palo Pinto County, Texas
Notarization: Not required: file this form without a notary.
Official source: co.palo-pinto.tx.us
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

Use this application when seeking county burial or cremation assistance for a person whose death occurred in Palo Pinto County. It asks about the deceased’s identity, residence, accounts, and relatives, as well as the applicant’s contact, household income, and employment information. A funeral home completes a separate section about its investigation of resources and referral efforts.

Who needs it

A person applying for assistance on behalf of the deceased completes the applicant section, while the referring funeral home completes its designated section.

How to submit it

The funeral home must first attempt to contact the deceased’s family and wait 72 hours for a response before referring the case to the County. The form does not provide a submission address or method.

About notarization

This document has no notary block; the applicant signs and dates sworn statements, and the funeral home informant also signs and dates its section.

How to submit this form

1
Download the Application
Download the Indigent Burial Assistance Application for Palo Pinto County.
2
Complete the Applicant Section
Provide the requested information about the deceased, relatives, and your household. Sign and date the sworn statements.
3
Complete the Funeral Home Section
The funeral home completes its designated section and makes the required family contact attempt before referral.
4
Refer the Application to the County
The funeral home must wait 72 hours for family members to respond to its initial contact attempt before referring the case to the County.

Frequently asked questions

Do I need a notary for the Indigent Burial Assistance Application?: No. The form has no notary block, though the applicant signs and dates sworn statements and the funeral home informant signs and dates its section.
How do I submit the Indigent Burial Assistance Application?: The form does not give a submission address or method. It says the funeral home must attempt to contact the family and wait 72 hours before referring the case to the County.
What information does the application ask for?: It asks about the deceased, living relatives, the applicant’s household and income, and the funeral home’s investigation of resources and referral efforts.
Who completes the funeral home section?: The funeral home completes the designated section, which asks about resource investigations, possible benefits, and other information relevant to determining eligibility.

Need something notarized?

This Application for Indigent Burial Assistance doesn’t need a notary, but Texas residents can notarize other documents online with a commissioned online notary.