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Certificate No. 2108
(CITY OF SEBSTIi1
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Ramona Widman and/or Christina Kelly 398 Fordham Street, Sebastian, FL 32958
(name) (address)
in and for consideration of the sum of $1,400.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following lots:
Unit 4_ Block _9_ Lots-36, 37
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 25th day of January, 2007.
OF �IJBASTIAN, FLORIDA A
tiivvimner Sall . Maio, MMC
City Manager City Clerk
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Name '
Unit
Block
Lot'
Date of Mark -out
Date of Burial
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Name of Funeral Home ZO
Authorized by `—�
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FLORIDA DEPARTMENT OF
HEALT State APPLICATION FOR BURIAL HTRANSIT a Vital
A. (TYPE)
1. Name of First Middle Last Date
Deceased William Edward Widman of
Death
2. Place of Death City, Town or Location Name of (If neither, give street address)
liffYn River Sebastian Hosp. or 398 Fordham Street
Inst.
3. Name of MVIRI Parvus, MD
Certifier
P.O. Box 6009, Vero Beach, Florida 32961
Month Day Year
January 25 2007
Phone Number
(772) 567 -0033
Medical Examiner I IN ysician
4. Name of Funeral Home /Direct Disposal Address 1655 27th Street Fla. Lic. No. /Reg. No. Phone No. (Area Code)
49@®t Lowther Funeral Home Vero Beach, Florida 32960 2559 (772) 778 -3233
5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. M
was contacted on
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that will complete and sign the medical
certification of cause of death within 72 hours.
C. was contacted on He /she verified that
Medical Examiner, will complete and sign the
medical certification of cause of death within 72 hours.
6. Funeral Director/ Si ture F.E. No. /Reg. No. Date Signed
Direct Disposer 2588 January 25, 2007
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 2559 -07 -020
A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
[:]No extension of time for fili the death certificate has been uest
Registrar or _. Date Date Certificate
Sub registrar Signature January 25, 2007 February 6, 2007
rn9 g �'� / v2 ued: Due: ry
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL- AT-SEA
Approval Number: Date
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
Method of Disposition: Place of Disposition Sebastian Cemetery
X
BURIAL STORAGE Date of Disposition
January 27, 2007
EICREMATION OTHER (Specify)
Signature of Sexton
or Person -in- Charge
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 County Health Department in the county where disposition occurred.
DH 326, 8197 (Obsoletes all previous editions) Distribution: White: Yellow: Funneral Director ortDir
ect Disposer
(Stock Number: 5740 - 000 -0326 -2) Pink: Local Registrar A-y-W
`S
SEBASTIAN
wllllam Widman
William Edward "Farm -
er Bill" Widman, 64,
died Jan. 25, 2007, at his home.
He was born in Pontiac,
Mich., and lived in Sebastian
for 28 years, coming from Fort
Pierce.
He worked as a commercial
fisherman before owning and
operating Sebastian Printing.
He was a veteran of the Air
Force.
Survivors include his wife of
38 years, Ramona Widman of
Sebastian; son, Rand Robinson
of Vero Beach; daughters, Kel-
ly Christena of Sebastian, and
Jane Wadsworth of Vero
Beach; and five grandchildren.
Memorial contributions may
be made to the North Indian
River County Library, 1001 Se-
bastian Blvd., Sebastian, FL
32958.
SERVICES- A graveside serv-
ice will be at 3:30 p.m. Jan. 27
at Sebastian Cemetery in Se-
bastian. Arrangements are by
Thomas S. Lowther Funeral
Home in Vero Beach.