The URL can be used to link to this page

Home My WebLink About3-60-03Namr �LtGry G IL FL LI ?1W Unit 3 Lam' 3 Date of Mark -out L ! a / G wt Date of Burial > 1'I I !L I Time I I r d 0 Name of Funeral Hommee,' S�Y�a,/ n j S Authorized by `_ v Y al Seawinds Funeral Home & Crematory Cheryl McCormick ( February 14, 1955 - February 15, 2021 ) Cheryl Janeen McComilck, 66, passed away in her home February 15, 2021 with her family by her side. She was bom a Valentines girl February 14, 1955 to John and Martha Brooks in Greenfield, Indiana. Cheryl was married to Roger McCormick on May 2, 1995. She was a 1973 graduate of Greenfield Central High School and she attended IRCC. Cheryl Worshiped at St. Sebastian Catholic Church. She was a longtime office manager for McCormick drywall, and worked at other bookkeeping jobs, but her favorite job was in the fulfillment department of Gmcewood Groves. An avid reader and tender of gardens, she never uttered the words "I am bored'. Cheryl was preceded in death by her daughter, Carrie Ann. In addition to her loving husband Roger, she is survived by her children, Janette, Michael, John, and Noah; five wonderful grandchildren she loved dearly. She will be truly missed. A private family service will be held for Cheryl. Funeral Director's Request to City of Sebastian for Burial Opening In Sebastian Municipal Cemetery Contact Information: Sebastian Municipal Cemetery Phone (772) 589-2545 Fax (772) 228-9927 City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 ctasta6.ci ofsebastian.ord Funeral Home: t Address: Phone: -lq�- 9•/. (Chec Open Burial Lot Lot Block i, v Unit , Open Cremains Lot Lot_ Block_ Unit_ Open Columbarium Niche Niche_ Block_ Unit (Cirdei N S E W Burial Date and Service Time:_ Vr dt?eA' V 4 7 t ani Deceased NamehP,{7l ) I�GI✓li�ll� m Name and Signature of Lot Owner or Representative: (p ust provide proper documental of ownership) FFlI/'�y�[•I- M Car ryN 1 CV � M q*cCe�vw,$ a- Pnn' f47ame Sign 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: LCl�i1RAZ/%'/7Y.cly i9-1&-z24 .-1 Print Name Signature ✓ 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: n/A-�-- a / l m7 / aaa l ery Sexton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. Funeral Director's Request to City of Sebastian for Burial Opening in Sebastian Municipal Cemetery Contact Information: Sebastian Municipal Cemetery Phone (772) 589-2545 Fax (772) 228.9927 City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 ctesta(& itvofsebastian.ora Funeral Home: f- Address: [.2� /Jor .5tA. Phone: •7�.>9• 3i (Chet Open Burial Lot Lot ✓ Block i, v Unit 3- Open Cramains Lot Lot Block Unit Open Columbarium Niche Niche Block Unit (Circle) N S E W Burial Date and Service Timv'r e:, vdn/14X.(ny k 7 I )1 awl Deceased Name:.Pwrq II�GI 1)✓Y)')I�X , Name and Signature of Lot Owner or Representative: ( unst provide proper documentail ,�,�{{�� of ownership) rtp t��r MCcfrmiM �( A h%cC,,,,rL I.-(6- a0Z) nn ame San re 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. N/aam� e-and Signature of Licensed Funeral Director: / nl ame Signature Date I certify that I have checked the ownership information by viewing the owners deed and confinning 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. arvof SESTL HOME OF PELICAN ISLAND Certificate No. 2737 cri Y OFSEBASTIAR Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Roger McCormick 2960 70`h Place Vero Beach, FL 32967 In and for consideration of the sum of $4,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 3, Block 60, Lots 3 & 4 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 12th day of February, 2021. CITY OF SEBASTIAN, FLORIDA ATTEST: Paul E. Carlisle City Manager zl� W'C'%L' c c-rn4 Jeanette Williams, MMC City Clerk CMC. SEBASTIAN HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772)589-5330 Phone (772) 589-5570 Fax February 16, 2021 Mr. Roger McCormick 2960 70" Place Vero Beach, FL 32967 RE: Interment Rights to Unit 3, Block 60, Lots 3 & 4 in the Sebastian Municipal Cemetery. Dear Mr. McCormick: Enclosed is City of Sebastian Certificate 2737 entitling you to full interment rights in Unit 3, Block 60, Lots 3 & 4 in the name Roger McCormick. If you have any questions, please contact our office at 388-8209. Sincere ly, y,Cathy T a Records Specialist Enclosure 0. a-7 3-7 tiOiQE OT PELIGSI LSIAnD City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Name(s) n %c ' 7 Dq1`1 Q Address -7 7A - 4-73 -o1�oq Area Code & Phone Number f�tG I11 � C�.ntil c k. Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: W-f'J 00 ,,II �Sr}np iamc{ �f -0 7 Dollars ($ D[XI. 170 ) on this 12,` ` day of Cla 2 VAA41 , 20a/ for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit 3 , Block i�d , Lot(s) 3 f T Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. Additional Fees paid at time of purchase: Corner Markers (set of 4 - $20) Opening & Closing Vase and Ring for Niches (cost) Interment Temporary Marker Preparation & Installation ' �T �� 1 Ignatur of Purchaser /w O H Circle One Disinterment �ty— TC O o e st The rollowing documents were provided as Proof of Residency: 1:14wV-DATAWs-CemeteryW ECEIPT.Eoc CITY OF SEBASTIAN 12618 ADMINISTRATIVE SERVICES RECEIPT Name - C'�"2-F'% r CK O Cash Date .4 ❑ Check # VCredR �'- Amount Paid 001501 362150 Non -Taxable Rent 001001 220000 Security Deposit 001501 362100 Taxable Rent 001001 208001 Sales Tax 450010 369900 Airport Badge 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 220030 PD SHOP 001501366602 PD SAFE 001501 366603 PD COPE boloio 81138cb oOD 0 Aix t�a to-'s 3+4 -� L� Total PM 1, - D'� comas While - Dept. of Origin •Yellow - Admin. Svcs. • Pink -Applicant CITY OF SEBASTIAN 12701 ADMINISTRATIVE SERVICES RECEIPT Name S-YAWn1DS 00&/IM!6 r' O Cash Date alas/aoAI VXheck# 3341 ❑ Credit 001501 362150 001001220000 001501362100 001001208001 450010369900 001001218010 001501364100 001501347557 001501341920 001501 351140 001501342100 001501 220030 001501366602 001501 366603 PD COPE on Sol 3+Sgl J&li.3 QIK60 LDT3 Initials Amount Paid Non -Taxable Rent Security Deposit Texable Rent Sales Tax Airport Badge CobraServe Code Enforcement Fines Community Center Revenue Copies Parking Citation Police Security Services PDSHOP PD SAFE Total d /�I 70677 White - Dept. of Origin - Yellow - Admin. Svcs. - Pink -Applicant State of Florida, Department of Health, Bureau of Vital Statistics O� BURIAL TRANSIT PERMIT i rtAff i DATE PRINTED: February 22,2021 TRACKING NUMBER: 2021035971 DECEDENT INFORMATION Name of Deceased Date of Death CHERYL J MCCORMICK Febmary 15, 2021 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH 295070TH PLACE Name and Address of Funeral ticumvDirect Disposal Establishment Fla. Lit. NodReg. No. Phone Number SEAWINDS FUNERAL HOME F073380 F073380 (772) 589-1933 735 SOUTH FLEMING STREET SEBASTWN, FLORIDA, 32958 Funeral Dlrectur Dian Disposer Fla. LIc. NolReg. No. KENDRA LEE MCDANIEL F421213 Medical Verification Statement VNA Nurse at We comfying physician's office , was contacted on 0211 W021 by Me funeral director listed above; he/she Indicated Met MICHAEL ANTHONY VERAZIO, certifying physician, will complete and sign Me medical certification of cause of death within 72 hours. 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382. Florida Statutes. Permit Number. 2021-F073380-5W4 Date Issued: February 18, 2021 Stale Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Autho ication given by Medical Examiner District 19 Approval Number. 4. CEMETERY OR CREMATORY Place of Disposition: SEAWINDS FUNERAL HOME Method of Disposition: BURIAL Date of Disposidon: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file May may do so. DH 328E, 10112 84V-1.011, Ficula Administrative Code