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Certificate No. 2123
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
Gaetano J. Leone
(name)
755 Dempsey Avenue, Sebastian, Fl 32958
(address)
in and for consideration of the sum of $350.00 is entitled to full interment rights in the
Sebastian Municipal Cemetery for the following lot:
Unit 4_ Block _13_ Niche(s)_ 16b_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 5th day of April, 2007.
STIAN, FLORIDA
41J Minner
ity Manager
ATTEST:
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Sall .Maio, MMC
City Clerk
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April 6, 2007
Mr. Gaetano J. Leone
755 Dempsey Avenue
Sebastian, FI 32958
RE.• Interment Rights to Unit 4, B/ock 13, Lot 166, Sebastian Cemetery
Dear Mr. Gaetano:
Enclosed is City of Sebastian Certificate 2123 entitling you to full interment rights in
Unit 4, Block 13, Lot 16b.
Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal
Cemetery.
If you have any questions, please contact our office.
Si ely,
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Sally A. aio, MMC
City Clerk
SAM:ar
enclosures
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City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
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Name(s) ~ ~.,
Address /
~ 9 _ 7.56
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
Dollars ($ ~S DD _ a d )
on this ~ day of ~ , 20~ for the purchase of the following
described Cemetery Lot(s) a d/or Niche(s).
Unit, Block~_, Lot(s) /~6 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:
Comer Markers (set of 4 - $20) Opening 8~ Closing W,Z~D ~ < w 1 O H
Circle One
Vase and Ring for Niches (cost)
Signature of Purchaser
Service fees are to be paid at time of need only
I:\W W-DATA\Ms-CemeterylRECEIPT.doc
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