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Home My WebLink About4-22-28Name Unit_ Block Lot Date of Mark -out T Date of Burial/ Z/-3 Time Name of Funeral Home �,- Z,e u� Authorized by GLORIA S. WHITAKER Mrs. Gloria S. Whitaker, 90, died June 27, 2013 at VNA Hospice House in Vero Beach. She was born August 15, 1922 in Newark, New Jersey and lived in Sebastian for 19 years coming from Miami, FL. Mrs. Whitaker was a graduate of St. Barnabas School of Nursing, Newark, NJ. She was a Registered Nurse and worked in Labor and Delivery at Baptist Hospital, Miami, FL for 20 years. She was a member of St. Sebastian Catholic Church, Sebastian, Florida and was a member of the Women's Guild, St. Timothy's Catholic Church, Miami, FL. Survivors include her son, Patrick D. Whitaker of Sebastian; daughter -in -law, Ellen Whitaker Dwelle (George) of Jacksonville; grandchildren, Jason Whitaker (Megan), Damon Whitaker (Dena), Kelly Whitaker; great - grandchildren, Dylan, Daniel , Logan, Sophia and Zachary. She was preceded in death by husband, Jerome J. Whitaker and son, Jerome J. Whitaker, Jr. FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY nrvn HOME OF PELICAN ISLAND 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 HOMEE A CREM RY ADDRESS: 1623 No. Central Ave. S94 "' 32958 PHONE #: (772) 589 -1000 ( h pck One) OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND ERVICE TIME FOR DECEASED: Name Lot �O Block 22--- Unit Lot Block Unit Niche Block Unit Mono N � -rr ° 00 /tAj NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: ust provide proper documentation of ownership) Name Signature Da e 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 SIGNATURE OF LICENSED FUNERAL DI Name Signature Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and thaA all fees have been paid �. �7, Cemqrfery 9ext n D to This form to be provided to Clerk's Office by Sexton for permanent record upon completion, CITY OF SEBASTIAN CITY CLERK'S OFFICE 4403 RECEIPT Name 5" t ra n k &L-falu- ❑ Cash Date ! fiCCheck # No. Amount Paid 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies /Bid Specs. 001501 341910 LDCICode of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots 2Z Lot/Niche , Block Unit 001501 343805 Cemetery Fees 156- 63 o J w Total Paid 15-0.00 Initials White - Dept. of Origin • Yellow - Finance • Pink • Applicant FLORLDADIIARrGti OE'. ,' State of Florida, Department of Health, Bureau of Vital Statistics 17L,T BURIAL TRANSIT PERMIT DATE PRINTED: June 28, 2013 TRACKING NUMBER: 2013093811 1. DECEDENT INFORMATION Name of Deceased Date of Death GLORIA SMITH WHITAKER June 27, 2013 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH VNA HOSPICE HOUSE Name and Address of Funeral Home /Direct Disposal Establishment Fla. Lic. No. /Reg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589 -1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 Funeral Director /Direct Disposer Fla. Lic. No. /Reg. No. WILLIAM B. WHITTAKER F026900 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2013- FO41870 -5103 Date Issued: June 27, 2013 4, t Meade Grigg, State Registrar J I AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY D no I I I Method of Disposition: BURIAL Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10/12 64V- 1.011, Florida Administrative Code aitU of Orhastian /� T r ut r t ie r g D e r b NO. THIS INDENTURE MADE Ttds ........ 4.th......... day of ....... June ............................... A. between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Gloria N. Whitaker _............................ ............................... ......... ..............................1 2 7.Friar C our t ............................ ..... ............. ............................... of the County of ... LnClja D..Rj.Ver ..................... an] State of ...... Kgri d..a............................... as Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ 1 ,.Q Q Q,, QQ, , , , , , , , , , , , , to it in hand paid, the receipt whereof is herewit knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ......... heirs, legal representatives and ass the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) ? 7 � 2 8 , Block, . Z ?.... , UNIT ....4........ , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Pla Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. i Attest: ............... .......... ......................... City Clerk Signed, Sealed and Delivered QIn the Presence of: .. A V . a .. '.\ .. ........ STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this .....4th .. .......... • .day or ..... June . , 2001 ........ .............................. .... CITY OF SEBASTIAN, FLORIDA By................. Mayor ((gitg Seal) before me personally appeared ..... Walter .W... Barnes ......................... and .$Ally..A.., Maio„ respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the individuuls and officers described in and who executed the foregoing conveyance to Gloria „N.,. Whitaker ........................... ............................... and severally acknowledged the execution thereof to be their free act and deed as such officers tbereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year last aforesaid. / .: *, H. ,JOANNE SANDQ�RG 1 :.; .: MY COMMISSION # CC 725642 Nota ublic, State of Florida at Large. Bonded XThiru Nootiary Pra6 Undd4w6ters My lesion expires: