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~bY CEMETERY Receipt No...... ?...... Dated..... ~.~!J.~ (.~ 7........... Lo t s 33,34,35 NO.
List Price s.. 200 .00....... Maximum No. BurialSpac:es...... 3......... Blk . 44, Un. 4
Net Paid $ ........... .6 QO... 00 Monument permitted..... Elat............ Fr ankHindra
Ii!rld:X'e-Eh Hindra interred Lot ~ - 12/18/87 526 Michael St.
..4.4...33 Sebastian, Fl.
-'7.A//l/n (Data abciycthlll1ne tor City Record cm1y)
1149
atitv Df &rbastian
OIrmrtrrg
Irrb
NO.
1149'
THIS INDENTURE MADE '11ala ...... .1.5.th. . .. .... day 01 ........ ..De.cember..................... A. 0.. 1..8.7...
between the City 01 SeblUitlan, a municipal corporation alatln. under the lawa 01 the State oi Florida, aa Grantor and
.... .. .... ......................;.... .f.:r.~n.k. .lI::indr.a............................................................................
526 Michael St., Sebastian, Fl.
. . . . . . . . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .......................... .' . . . . . . . . . . . . . . . .. ............................................
01 the County 01 ............ ~~.c;l':!'~n ..~.~ ~~;-............ aD'J State 01 ....... ..li';I, 9.+.i~A..................................
.. Grantee, WITNESSETH. .
That the Grantor for and in consideration of the sum of $ ... ~ ~ 9. ~ 9.9. . . . . . . . . . . . . . to it in hand paid, the receipt whereof is hereWith ao-
knowledged, does by this instrument grant, bargam, sell, release, convey and confirm unto the Grantee . . . . . . . .. heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
All of Lot(s) 3.3.t_~~ck, . .41+.... ,UNIT ..... .4...... ,of Sebastian municipal cemeten' as per Plat Number 1 thereof recorded in Plat
Book 2, at page 6Sof the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being
in Indian River County, Florida.
To Have and to HOld the same forever; provided that said Property shall be. used solely and eXclusively for the interment of the human Jead and. shall
be used. kept and maintained at aD times in accordance with the rules and reguJadons,: ordinances and resolutions of the City of Sebastian, Florida, hereto-
fore"now and hereafter adopted or provided for tho government and operation of said cemetery. The conditions, restrictions and requirements contained
in this instrument shall be covenants ruiming with tho land. In the event of tho failure of the owner of any property situated within said cemetery to ob-
serve and comply with iuch rules, regulations, resolutions and ,ordinances and the conditions of the deed of conveyance thereof then the title of such owner
in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of tho first part haa caused this instrument to be executed in its name and on its behalf by its Mayor and
attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written.
Attl!stl4~. . lb..,. {)'.da.Ut:1~.........
# . City Clerk
Signed, Sealed 1100 Delivered
~re&ence 011 . ~
~:..,..~......
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((l[itv Jieal)
STATE OF Fr..oRIDA
COUN'ty OF INDIAN RIVER
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State of FlorIda, Departmen~1th and Rehabilitative Services, Vital SWJcs
APPLICATIOWOR BURIAL - TRANSIT PERMIT .
A.
1. Name of
Deceased
(Type or Print)
First
FRANK
Middle
Last
HINDRA
DATE Month Day Year
OF
DEATH July 25, 1992
2. Place of Death
County
Brevard
City, Town or Location
Melbourne
Name of (If neither, give street address)
Hasp. or
Inst. Holmes R.egional Medical
Address
Center
3. Name of Medical I-J Medical Examiner
Certifier
Peter P. Zabinski ItlPhysician 7742 Bay St.H12,
4. Name of Funeral Homel Address
Sheet O*eer 1623 N. Central Avenue
Strunk Funeral Home Sebastian, Florida 32958
5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies
Appro- this application.
priate
Box
Phone Number
Sebastian, Florida 32958 407-589-6022
Aa. We. No.1 _..' I ~_._ Number (Area Code)
1228 407-589-1000
b !J
Dr. Zabinski was contacted on 7/26/92 within 72
hours after death. Hel she verified that this death 1': from natural causes. that there was no accident
nor other external cause of death, and that e will complete
and sign the medical certification of cause of death.
c 0
was contacted on . Helshe verified that
. Medical Examiner, will complete and sign the
6. Place of Sebastian,
Final Disposition: Flor da
7. Funeral Director I
gj,.....l~~.....
F.E. No.l~. fb-
1672
Removal
from state Donation
Date Signed
7/27 f92
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body.
o A fIVe day extension of time for filing the death certiflC8te (exclusive of weekends) has been requested and granted as undue hardship
would result from filing within the normal time limit If the certificate cannot be filed within this extended time limit, a "Funeral DirectorlDirect
Disposer Report" will be filed with the Local Registrar of the County in which death occurred.
o No extension of time for fI the de certificate sted.
Registrar or
Subregistrar Signature
PermrrNo. 1228-92-0354
Date
Issued:
7/27/92
Date Certificate
Due:
C.
AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA
Signature . Medical Examiner Date
or
Medical Examiner, . gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after
death is required for all cremations.
D.
CEMETERY OR CREMATORY
Methods of Disposition:
(] BURIAL
o CREMATION
Signature of Sexton )
or Person-in-Charge )
o STORAGE
o OTHER (Specify)
A" "I '1 ~ .L:., 7-'
Place of Disposition Sebastian Cemetery
Date of Disposition July 28, 1992
This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton)
and returned within 10 days to the local HRS County Public Health Unit in the County where disposition occurred.
HAS Form 326. Feb 89 (Replaces Oct 87 edition which may be used)
(Stock Number. 5740-000-0326-2)
:).