HomeMy WebLinkAbout1-25-40Name G
Unit
Block
Lot A
Date of Mark -out
Date of Burial y/ 9 / ��- Time �� �g Z '
Name of Funeral Home
Authorized by
Name
Unit
Block
Date of Mark -out
' r
Date of Burial Time A
Name of Funeral Home
Authorized by
16'7548
WARRANTY DEED
INDIVID. TO INDIVID
RAMCO FORM 01
This arranty heed Made lice day of June A. D. 19 ?6 by
Glendy and Cora Sad:l er, Yiusband and wife
hereinafter called the grantor, to Sembler
Vernie W.
Rt. 1 Box 50, Sebastian Fla. 32958
10
ALL
whose postof Tice address is
hereinafter culled lice grantee:
(Wherever used
legal herein rand Kassligns of n individuals, include
successors and ands assignslsof scorporations)
biltnesseth. I'hal the grantor, for and in consideration of the sum Of $ /0 0 1/'C and Other
valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, alien, re-
mises, releases, conveys and confirms unto lice grantee, all that certain land situate in 1�- t i `A (fit L I `A' Lj
County, Florida, viz: /►
Section B, Lot 11 Block 25
Grave Space for Lot in NE corner) 6
Sebastian Cemetery (Old Section)
Joyther with all the tenements, hereditaments and appurtenances thereto belonging or in any-
wise appertaining.
To U40C and to told, the same in fee simple forever.
I1n nd the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land
in fee simple: that the grantor has good right and lawful authority to sell and convey said land; that the
grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of
all persons whontsoever; and that said land is free of all encumbrances, except taxes accruing subsequent
to December 31, 19
(No taxes on cemetery lots)
�n '"itness jUhereof.. the said grantor has signed and sealed these presents the day and year
first above written.
Signed, sealed and delivered in our presence:
i
cb...... .....
STATE OF
COUNTY OF j
I HEREBY CERTIFY that on this day, before me, an officer duly
authorized in the State aforesaid and in the County aforesaid to take
acknowledgments, personally appeared
co me know,p , x.:11 the person described in and who executed the
forgoing ih41iument d :
�J
WARRANTY DEED
INDIVID. TO INDIVID
This IgArrAfity Deed Made the
167548
day of rune
Glendy and Cora Sadler, husband and wife
RAMCO FORM O
A. D. 197 6 I
hereinafter called life grantor, to Vernie W. Sembler
Rt'. 1 Box 50, Sebastian Fla. 32958
whose posluf five address is
hereinafter culled Cite grantee:
(Wherever used herein the terms "grantor" and " vantre" include all the parties to this instrumcut and
the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations)
Uitnesseth: That the grantor, for and in consideration of the sum of $ /U 0 VC aril oil
valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, 1
mises, releases, conveys and confirms unto fire grantee, all that certain land situate in {,j t(lA. iA.t L
Courtly, Florida, viz: 1
Section B, I,ot 1, Block 25
Grave Space for Lot i.n NE corner).6
Sebast.i.an...0em
00"S R
t
�. ,
--
' i I
�1
Together with all Cite tenements, hereditament , and appurtenances thereto belonging or in a
wise appertaining.
'fo 'Rapt and to Uotd, the same in fee simple forever.
Rnd lire grantor hereby cot,ertants with said grantee that the grantor is lawfully seized of said lc
in fee simple; that lite grantor has good right and lawful authority to sell and coru+ey said lurid; that
grantor hereby fully warrants the title to said land and will defend the same against the lawful quints
"all' Nersti "its whoyi►sog,s i= ;-urtd t1 at said -lan,4 as free - -of all encumbrrances, axcept taxes accruing subsego
to December 31, 19
(No taxes on cemetery lots)
hwitness whereof, lite said grantor has signed and sealed these presents the day and
first above written.
Signed, sealed and delivered in our presence:
t
SPACE REIOW FOR RECORDERS USE
STATE OF -
�ta�tt~.>I� �Gt�t�tnal<azv
Certificate of Cremation
The cremated remains contained in this container are those of the body of
Charles Donald Sembler
as delivered to us for cremation on the � ay of April
20 10 by Lowther Cremation Service, Inc., Vero Beach, Florida.
Permit No. 2559 -10 -132
Issued at 1555 27th Street, Vero :Beac , Florida 32960.
(Cremated remains have been
wrapped in a plastic pouch.) Bye/
772 - 770 -5795 0 www.lowthercremationservice.com
CITY OF SEBASTIAN
CITY CLERK'S OFFICE /.
RECEIPT 4
Name Jlu- ct 4 K) 0 f 0 Cash
Date L3 XCheck #�
No. Amount Paid
001001208001
Sales Tax
001501322900
Garage Sales
001501341920
Copies/Bid Specs.
001501341910
LDC /Code of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots
Lot/Niche 10 6.1'�b, Block Unit 0
001501343805
Cemetery Fees
'- I@ S50.� /
Total Paid &0. 00
Initials
White — Dept. of Origin • Yellow — Finance • Pink • Applicant
No. 13417
Certificate of Cremation
For
Vernie W. Sembler
Who died March 26, .20 13
was cremated at Woodlawn Crematory,
and these are the cremated remains of deceased.
W odlawn Crematory
y
Funeral Director
Robin J. Fisher
Woodlawn Crematory
400 Woodlawn Cemetery Road
Gotha, Florida 34734
TO: NATIONAL CREMATION & BURIAL
7565 Red Bug Lake Road
Oviedo, Florida 32765
Cremated Remains of: VERNIE W. SEMBLER
PERMIT AND CERTIFICATE ENCLOSED
STATEMENT 099018
Date
TO �.J u ,li y �a �tl
/ TERMS
IN ACCOUNT WITH,��
Stock Form 25812
MR
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
SEAT_"
NOhil tii CFLICAN 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:
ADDRESS:
PHONE #:
(Che,One)
---' PEN BURIAL LOT Lot 10 Block _Unit
:OPEN CREMAINS LOT Lot _Block Unit
_SJPEN COLUMBARIUM NICHE Niche Block Unit
W
BURIAL DATE AND SERVICE TIME:
FOR DECEASED:
ivame
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentatioii 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 SIGNATURE OF LICENSED FUNERAL DIRECIOR.
1114
Name Signature Date
----------------------------------------------------------------------------------------------------
Cemetery Sexton Certification:
I certify that I have checked the ownership infoririation by viewing the owner's deed and confirming
with Clerk's office ;ind that all fees have been paid
Ao��q a - /?/Z / -
_Cemekry xton Dat
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
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FLORIDA DlrAmC tEgr OF. ,�� State of Florida, Department of Health, Bureau of Vital Statistics
HEALT BURIAL TRANSIT PERMIT
DATE PRINTED: March 28, 2013 TRACKING NUMBER: 2013046867
1. DECEDENT INFORMATION
Name of Deceased Date of Death
VERNIE W SEMBLER March 26, 2013
Place of Death - County City, Town or Location Name of facility, or street address if not a facility
SEMINOLE .ALTAMONTE SPRINGS HOSPICE OF T-IF COMFORTER- HOSPICE HOLSE
Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No.rReg. No. Phone Number
NATIONAL CREMATION & BURIAL SOCIETY - OVIEDO F04C304 FW304 (407) 3E5 -1500
7565 RED BUG LAKE RD
OVIEDO, FLORIDA, 32765
Funeral Director /Direct Disposer Fla. Lic. No. /Reg. No.
RCBIN J. FISHER F042C56
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- F040304 -5173
Date Issued: March 27, 2013
u. J
Meade Grigg, State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District 7 Approval Number: SM12285
4. CEMETERY OR CREMATORY
Place of Disposition: WOODLAWN CREMATORY
Method of Disposition: CREMATION Date of Disposition:
EDRS maintains all statutorily required information regarding the death record an trela ted
burial transit permit, therefore, returning the permit to the county health departmno
long er required.
If the Place of Final Dispo i on wishes to retain the copy of the permit for their file they may do so.
DH 326E, 10112
64V- 1.011, Florida Administ ative Code
900/L00 d 9Z6# c9:9L CL0Z /R/co L6LZ99CZOb:I110.j