HomeMy WebLinkAbout3-COL-43SnFuneral Director's Request to City of Sebastian for Burial Opening in Sebastian
Municipal Cemetery
Contact lnformation:
Sebastian Municipal Cemetery
Phone (772) 589-2545
Fax (772) 228-9927
City Clerk's Office
Cathy Testa
City Hall, 1225ltAain Street
Sebastian, FL 32958
Phone (772) 388-8209
ctesta@citvofsebastia n.orq
Funeral
Add
Pho
(Check)
Open Burial Lot
Open Cremains Lot
\/ open Cotumbarium Ntcnehd LW
Lot_
Ni
(Circle)
Unit_
unit 3EW
Block_Unit
Lot_ Block_
"n$'*,"""6
Burial Date and Service Time
Deceased Name
Name and Signature of Lot Owner or Representative
(Must provide proper documentation of ownership)
Print Name Signature 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 Licensed Funeral Director:
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 Sexton Certification:
Cemetery Sexton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion
Print Name U Sisnature ()