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HomeMy WebLinkAbout4-31-50w~~~ ~ ;~,.. .: ~.-~3 HOME QF PELICe~N ISI.Al+iD 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. Address Area Code & Phone Number-o ~ ~ ~ ~ Name & Residence ddress of Intend Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: Ilars ($ ~a~o ~ ) on this. day of , 20~ for the purchase of the following described Cemetery Lot(s) and/or Niiiche Unit ~, Block ~ IVY ,Lot(s) 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 /W O H Circle One Disinterment _ TOTAL $ IoZ~O ~© Signature of Purchaser Sebastian The following documents were provided as Proof of Residency: I:\W W-DATAU1As-Cemetery\RECEI PT.doc C, 1 ' 5 ,~ G~ ~ i n . N V~ T ~ ~ J -~'I' a 1 A 3 N N 1 I `tl • n~ A P ti w ~ (,I~O ~~ ~, ~ ~ \ ~_ `I ~\ r ~~ ~~ A ~ n ~ ^ ~ ~ ~ ~ v m ~ r ~ o ~' ~' ~ '~' ~ ~, S p O NO ~ O O ~ O ~ O ~ pS p ~ Y S ~~p,/ O O NN O ~~~~~~ffF a ~o 6~ ~~~~~~~~ ~, ~~ A ~yy RI I~~ m V V