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Certificate # 1964
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Ruth M. Coleman
(name)
8309 Chinaberry Road, Vero Beach, Fl 32963
(address)
in and for consideration of the sum of 1900.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plots:
Unit _ 4_ Block _16_, Niches_ 25 & 26_
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 14th day of June, 2004
OF SF�B�ASTIAN, FLORIDA
��R. Moore
Manager
ATT�ST:
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S A. Maio, CMC
City Clerk
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City of Sebastian Municipal Cemetery
Purchase Receipt
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To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whorn lot is intended for interment must be
at time of purchase
Name(s)
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Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
pt is acknowledged in the sum of:
� Dollars ($ / ��� O� )
on this day , 200�%for the purchase of the following
describe Cemetery Lot(s nd/or Niche(s).
Unit �, Block �_, Lot(s) ��i`a?,� 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:
Corner Markers (set of 4-$20) Opening & Closing
Vase and Ring for Niches (cost)
Disinterment
W O H
Circle One
� ' T TAL $/ 900. a o
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Signature of Purchaser City of Sebas ' n
Service fees are to be paid at time of need only
I:\W W-DATA\Ms-CemeterylRECEI PT.doc