HomeMy WebLinkAbout3-65-06Name
Unit 3
Block v
Lot
Date of Mark -out
Date of Burial
Name of Furneral Home
Authorized by `� "
Funeral Director's Request to City of Sebastian for Burial Opening in
Sebastian Municipal Cemetery
Contact Information:
City Clerk's Office
Cathy Testa
City Hall, 1225 Main Street
Sebastian, FL 32958
Phone (772) 388-8209
ctestaQucitvotsebastian.or,
Funeral Home: Strunk Funeral Homes & Crematory
Address:1623 N Central Ave, Sebastian, Florida 32958
Phone:772-589-1000
(Check)
Open Burial Lot
E_ Open Cremains Lot
Open Columbarium Niche
Burial Date and Service Time: 3/19/2025 12:00pm
Deceased Name: John A Felice
Unit Block65 Lots
Unit_ Block_ Lot_
Unit
Name and Signature of Lot Owner or Representative:
(Must provide proper documentation of ownership)
Print Name Signature
Address Phone Number
Block_ Niche_
Date
I certify that I have determined the ownership of the above -described site that all site fees and
administrative fees have been paid and authorized opening of same.
Name and Signature of LicenC¢.Funcre, Director:
Sandra Mastrando 5� / (� 03/1312025
Print Name S gnature — Date
I certify that I have checked the ownership information by viewing the owner's deed and
confirming with Clerk's Office and that all fees have been paid:
Cemetery Certification:
emetery /
31/k/2s
Date
This form is to be provided to Clerk's Office for permanent record upon completion.