HomeMy WebLinkAbout3-37-15Name A
Unit 7
Block
Lot L
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Date of Mark -out / //^2
Date of Burial
Name of Furneral Homer�d7-2 Pj,//-9!�
Authorized by
State of Florida, Department of Health, Bureau of Vital Statistics
MUM BURIAL TRANSIT PERMIT
HEALTH DATE PRINTED: September 9. 2025 TRACKING NUMBER: 2025166012
1. DECEDENT INFORMATION
Name of Deceased Date of Death
RUBEN CABALLERO MELENDEZ September 9, 2025
Place of Death - County City, Town or Location
Name of facility, or street address if not a facility
BREVARD MELBOURNE
ST FRANCIS REFLECTIONS
Name and Address of Funeral Home/Direct Disposal Establishment
Fla. Lic. No./Reg. No. Phone Number
BROWNUE-MAXWELL FUNERAL HOME PA F040412
F040412 (321) 723-2345
1010 EAST PALMETTO AVE
MELBOURNE. FLORIDA, 32901
Funeral Director/Direct Disposer
Flay Lic. No./Reg. No.
RYAN C BROWNLIE
F043430
Medical Verification Statement
Jenny at the certifying physician's office, was contacted on 09/09/2026 by the
funeral Director listed above; he/she indicated
that RYAN BARRY CHAPMAN, certifying physician, will complete and sign the 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: 2025-FO40412-5483
Date Issued: September 9, 2025
State Registrar ,
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: SEBASTIAN CEMETERY _
Method of Disposition: BURIAL Date of Disposition:
s EDRS maintains all statutori!y reaaadirnn the Beath 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 they may do so.
DH 326E, 10/12
64V-1.011, Florida Administrative Code
BROWNLIE - MAXWELL FUNERAL HOME PA
1010 EAST PALMETTO AVENUE
MELBOURNE, FLORIDA 32901
INTERMENT ORDER
FD in charge: Ryan Phone (321) 723-2345
Alternate (321) 723-3167
NAME OF DECEASED: Ruben Caballero Melendez
DATE OF BIRTH: August 7, 1945 DATE OF DEATH: September 9, 2025
SS #: 581-84-3350 AGE: 80
NEXT OF KIN: Felicita Franco De Caballero RELATIONSHIP: Wife
ADDRESS: 102 W Melbourne Avenue, Melbourne, FL 32901
PHONE: OTHER PHONE:
CEMETERY: Sebastian Cemetery
DESCRIPTION: Unit 3, Block 37, Lots 15 & 16
Please call if the description is blank or not correct
INFORMATION RE:
DATE AND HOUR OF SERVICE: Friday 9/12 @10AM
DATE & HOUR OF BURIAL: Friday 9/12 @10AM
KIND OF SERVICE: Graveside
PLACE OF SERVICE: Sebastian Cemetery
OUTER CONTAINER: Unsealed grave liner
CASKET AMES, Min, Metal 20ga Blue finish, White crepe int.
THIS IS NOTIFICATION TO THE CEMETERY FOR INTERMENT. PLESE CALL OUR
OFFICE TO VERIFY THIS INFORMATION WAS RECEIVED AND IS CORRECT WITH YOUR RECORDS.
A COMPLETE SET UP IS ALWAYS REQUIRED.
CITY OF SEBASTIAN 17024
FINANCE DEPARTMENT RECEIPT
Name CpALI CL I l el'-O u Cash
Date ` - ZoZ 5 _ )4Check # 1 Zy
D Credit
Amount Paid
001501 362150 Non -Taxable Rent
001001 220000 Security Deposit
001501 362100 Taxable Rent
001001 208001 Sales Tax
450010 369900 Airport Badge
450010 362521 AP Shade Hangar Rent
450001 208045 Airport Sales Tax
001501 347557 Community Center Revenue
001501 341920 General Fund Copies
001501 354100 Code Enforcement Fines
601010 343800 Cemetery Lot Sales
001501 343805 Cemetery Fees/50.00
480010 341920 Bldg Dept Copies
PD Shop with a Cop
PD COPE
PD Cadets
PD SRT
3, 837 Ln6 15
Total Paid 15 U .00
Initial
White - Dept. of Origin Yellow - Finance Dpt. • Pink -Applicant