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* Indicates that this page was lasted updated March June 14 2013.

 

Administrative Fee Schedule
The Mortuary and Cemetery Board may charge a fee reasonably calculated to reimburse the agency for costs of providing and conveying copies of public records. A schedule of administrative fees will be approved as necessary by the Board and will be made available to the public. All fees must be paid before public records will be available for inspection or copies. OAR 830-020-0050(1)(2)

 

At the July 2013 Board meeting, the following administrative fees were approved by the Board:  Schedule 

 

Forms

For Individuals:


  1.   Memorandum on misrepresentation on an application.  *
  
  2. Address Change Form for Individuals Form (Note - If you are an active apprentice, you must submit the Transfer of Apprenticeship form (not this one!) with reissue fee(s).) 
  
  3. Death Care Consultant Application 

  4. Embalmer Apprenticeship (Only) Application See Embalmer & Funeral Service Practitioner (FSP) Apprenticeship Application if applying for both.
 
  5. Embalmer Apprenticeship Completion Form   (Application for licensure through the apprenticeship program.)
 
  6. Embalmer Apprentice Log Sample (PDF version) 
  
      Embalmer Apprentice Log Sample (Word Version) 
  
  7. Embalmer & Funeral Service Practitioner (FSP) Apprenticeship Application 
 
  8. Embalmer & FSP Apprenticeship Completion Form   (Application for licensure through the apprenticeship program.)
 
  9. Embalmer and / or FSP Apprenticeship Transfer Request  
 
10. Embalmer License Application (Non-reciprocal related application.  Note to Oregon FSP apprentice - use Form # 4 above.)
 
11. Embalmer License and Funeral Service Practitioner License Application (Non-reciprocal related application.  Note to Oregon embalmer & FSP apprentice - use Form # 7 above.)
 
12. Embalmer & FSP License by Reciprocity Application  
 
13. Embalmer License by Reciprocity Application 
 
14. FSP Apprenticeship (Only) Application   (See Embalmer & Funeral Service Practitioner (FSP) Apprenticeship Application if applying for both apprenticeships.)
 
15. FSP Apprenticeship Completion Form   (Application for licensure through the apprenticeship program.)
 
16. FSP Apprentice Log Sample (PDF Version) 
  
     FSP Apprentice Log Sample (Word Version) 

     (Note that only at need arrangements will count towards completion of FSP apprenticeship.) 
 
17. FSP License Application   (Non-reciprocal related application.  Note to Oregon FSP apprentice - use Form #14 above). 
 
18. FSP License by Reciprocity Application   
 
19. Intern Apprentice Application   Effective July 1, 2009:  An intern apprentice is any student enrolled in an accredited funeral service education program who is serving his / her three-month internship under the supervision of a combination licensed funeral service practitioner / embalmer at a participating funeral establishment.
 
20. Preneed Salesperson Application (For selling trust funded prearrangements only.)
 
21. Wall Certificate Order Form   
 
Licensing Related, Facility:
 
22. Initial Facility Application Process (Includes Change of Ownership application process also.)
 
23. Address Change Form for Facilities (To change mailing address or location of records.) 

24. Alternative Disposition Facility  (A Background Information Questionnaire needs to be completed and attached to the crematorium application for each identified principal on the application.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.)  *
 
25. Applicant Facility Owner Information Sheet  (If applicant facility is owned by more than one level of ownership, this form needs to be completed and submitted for each level of ownership above level 1.) 
 
26. Application for Change of Principal Form   (Pursusant to OAR 830-040-0000(5), when there is a change in any principal of the licensed facility, the licensee shall provide the Board with the name of the proposed principal(s) on a form provided by the Board within 30 days of the change.)
 
27. Background Information Questionnaire (For initial or change of ownership facility applications.  If facility is already licensed, use the Application for Change of Principal Form.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.)
 
28. Cemetery, Change of Ownership Application (A Background Information Questionnaire needs to be completed and attached to the cemetery application for each identified principal on the application.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.)
 
29. Cemetery, Initial Application   (Please attach a completed Cemetery Licensing / Registration Questionnaire form.  Note that a  Background Information Questionnaire will also need to be completed and attached for each identified principal.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire. ) 
 
30. Cemetery Guidelines 
 
31. Cemetery Licensing / Registration Questionnaire 
 
32. Certificate of Removal Registration  (Allows funeral directors employed by a licensed FE licensed in a contiguous state to remove human remains from Oregon before submitting a death certificate.)
 
33. Crematorium, Initial Application (A Background Information Questionnaire needs to be completed and attached to the crematorium application for each identified principal on the application.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.) 
 
34. Crematorium, Change of Ownership Application (A Background Information Questionnaire needs to be completed and attached to the crematorium application for each identified principal on the application.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.)
 
35. Funeral Establishment, Change of Ownership Application (A Background Information Questionnaire needs to be completed and attached to the funeral home application for each identified principal on the application.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.) 
 
36. Funeral Establishment, Initial Application (A Background Information Questionnaire needs to be completed and attached to the funeral home application for each identified principal on the application.  If any of the proposed principals currently holds a personal license issued by the Board, the proposed principal does not need to submit the Background Information Questionnaire.)
 
37. Funeral Establishment Licensing Overview & Guideline
 
38. Location Change Application, Facility 
 
39. Name Change Application, Facility
 
 
Compliance Related: 
 
40. Embalming Authorization (sample)

41. Interment Authorization and Authorization for Scattering Services (PDF) (Sample) 

      Interment Authorization and Authorization for Scattering Services (Word) (Sample)     

42. Receipt for Cremated Remains (Sample) 
  
43. Body Hold Notification form (10 day 24 and 48 hour reporting) (Word) *

44. Body Hold Notification form (10 day or 24 and 48 hour reporting) PDF *
 


Other: 
 
46. Indigent Burial Refund Form  
 
Unable to find a form?  Please contact the Board office and request assistance.
 

Oregon Mortuary and Cemetery Board
800 NE Oregon Street, Suite 430
Portland OR 97232-2195
971-673-1507
971-673-1501 - fax