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Certificate No. 2055
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
James F. Coker 5387 Hammerstone Court, Micco, Fl 32976-7708
(name) (address)
in and for consideration of the sum of $1,125.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following plot:
Unit 4 Block _18 Lot(s)Niche(s)_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 8th of December, 2005.
JRIDA ATTES~
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Sall aio, MMC
City Clerk
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1225 Main Street, Sebastian, F132958
Telephone (772) 589-5330 -Fax (772) 589-5570
December 8, 2005
James F. Coker
5387 Hammerstone Court
Micco, Fl 32976-7708
Dear Mr. Coker:
Enclosed is City of Sebastian Certificate 2055 entitling you to full interment rights in Cemetery
Lot 4, Block 18, Unit 4. Also enclosed is a copy of the receipt and the Rules and Regulations
governing the Sebastian Municipal Cemetery.
If you have any questions, please contact our office.
Sin re
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Sally Mai , MC
City Clerk
SAM:ar
enclosure
S~~AST~ ~
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HOi41E OF~vPEUUN IS(AND
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, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
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Address
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
~~ ~~
Dollars ($1 /-~ rJt~ )
on this day of ~s1-~-cps--~', 20 ~~or the purchase of the following
described Cemetery Lot(s) and/or Niche(s).
Unit ~, Block /~' ,Lot(s) Niches
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
W O H
Circle One
Disinterment
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Signature of Purchaser
of Sebastian
Service fees are to be paid at time of need only
1:\W W-DATA\Ms-Cemetery\RECEIPT.doc
793
J. B. COKER ~ s3-4/630 FL
5387 F{gMMERSTONE CT. l '' 1294
MICCO, FL 32976 Hate l ~ / ~ ~ /~ j
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Stock Form 25812