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Home My WebLink About2-08-02I^,� _.. � � �I fl � l• II i I i Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries ( Newspaper D... Page 1 of 1 VAN LETON PATE SR. Van Leton Pate Sr., 76, of Sebastian, died June 21, 2008, at Haven Hospice in Chiefland. He was born in Cordova, Ala., and was a former commerical fisherman in Sebastian for 26 years. He served in the Air Force for 20 years during the Korean War and Vietnam War. He was a member of the U.S. Sergeant's Association, and Organized Florida Fisherman's Association. Survivors include his wife of 53 years, Evelyn "Skeet" Pate of Sebastian; son, Van Pate Jr., of Vero Beach; daughters, Vanessa McNeil of Branford, Frances D'Ambrosio of Blackshear, Ga.; sisters, Delma Madison of Cordova, Audie Jack Mullings of Leadville, Colo., Nancey Jinright of Prattville, Ala.; 7 grandchildren; 2 great - grandchildren. He was predeceased by two sisters, Thelma Keys, and Tommie Jean Sanford, SERVICES: Visitation will be from noon to 2 p.m., June 25 at Strunk Funeral Home, Sebastian. A funeral service will follow at 2 p.m., in the funeral home chapel with Rev. Dave Foster officiating. Burial will follow at Sebastian Cemetery with full military honors conducted by the Sebastian Area Veterans' Honor Guard. Published in the TC Palm on 6/23/2008. Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Powered by Legagxom obituaries nationwide Back http:// www .legacy.com/tcpalm/Obituaries. asp ?Page= LifeStoryPrint &PersonID= 11211... 6/23/2008 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY MCI $EBASTtgjy r HOME yO,F PELICAN ISUND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home 8 Cremator ADDRESS: -1623 N,. Central Avenue, Sebastian, FL PHONE #: 772-2589-1000 (Check One) 1\rr OPEN BURIAL LOT Lot _ z Block 8 Unit 2 OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: 2 P.M. June 25, 2008 FOR DECEASED: Van Leton Pate, Sr. Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Name Signature Date I certify that I have determined the ownership of the above described site, that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNAT RE OF LICENSED FUNERA I OR: Name Signature Date Cemetery Sexton Certification: certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: Cemete Se on Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. f DEPARTMENT OF ALT State of Florida, Department of Health, Vital Statistics g APPLICATION FOR BURIAL - TRANSIT PERMIT A. (TYPE) 1. Name of First Middle Last Date Month Day Year Deceased Van L. Pate of 06 21 2008 Death 2. Place of Death City, Town or Location Name of (If neither, give street address) CountyjjeVy Chiefland, Florida Hosp. or Haven Hospice of the Tri- Counties Inst. 3. Name of Medical Address Phone Number Certifier Dr'.Geraldine Bichier 311 N.E. 9th Street Medical Examiner FlPhysician Chiefland,FL. 32626 (352) 493 -9898 4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment �? 17("Y4 ("Y4 PO Box 1399 • �, - - T' -@--1 0 - ----- Chiefland, FL. 32644 2482 ( 352) 493 -0050 5. Check a. ❑ The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b Catherine of Hospic a was contacted on 06/21/2008 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Bichier 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/ Signature F.E. No. /Reg. No. Date Signed Direct Disposer F044115 06/21/2008 ocl B. BURIAL - TRANSIT PERMIT ; i Permission is hereby granted to dispose of this body. Permit No. 2422OMP 3 r� 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 f r filin a eath ce icate has been requested. Registrar or Date 06/21 /2008 Date Certificate 07/01/2008 Subregistrar Signature Issued: Due: 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 Sebastain Cememtery on BURIAL ❑STORAGE Date of Disposition 4 AIS-A lg ❑CREMATION ❑OTHER (Specify) Signature of Sexton 1 �2 � or Person -in- Charge J) //� 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. Distribution: White. Cemetery or Crematory DH 326, Number r 5740-0 all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number 5740 - 000 - 0326 -2) Pink: Local Registrar Paid by General Receipt No. .... Z. %$.......... Dated. WAXCh..13., .19.80....... . List Price �'�. *,?, Q•Q .•QQ,* * .. Maximum No. Burial spaces .... 2 , .... . Discount $ .................. Total area in square feet Net Paid Monument permitted ... flat ............ R &R Attached (Data above this line for City Record only) Name_ lyMit -_ DEED #386 Van L. or Evelyn J. Pate 10th Street, P.O. Box 743 Sebastian Block 8, Lots 1 & 2 - Unit 2' Block \ Lot ' f Rate'of U**-out Date of Burial- ( f -/4o Time Name of Funeral me Authorized by AL 0 0 J �L� C Ce °Q m S Y Xr LAI M l O CO 616 DEED #386 Van L. or Evelyn J. Pate 10th Street, P.O. Box 743 Sebastian Block 8, Lots 1 & 2 - Unit 2' Block \ Lot ' f Rate'of U**-out Date of Burial- ( f -/4o Time Name of Funeral me Authorized by AL 0 0 J �L� C Ce °Q m S Y Xr LAI M l O CO