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THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS /HEREBY ACKNOWLED L) OFF THE SUM OF:
l lull L-Zz�-t— K a ' Dollars ($ 0200. )
FROM :�P
on this
day of u 'I 1.981 for the purchase of the following
described Cemetery Lot(s) ui6on the terms and conditions as stated herein:
Description of Property
. Cemetery Lot(s)#—A5—'.11(0 Block# j Unit# oZ
Purchase Price Bey -- Dollars ($ QUO-" )
Terms and conditions of sale:
This contract shall be binding upon both parties, the seller and the purchaser, when
approved by the owner of the property above described.
X. or we, agree to purchase the above described property on the terms and conditions
stated in the foregoing instrument:
The City of Sebastian agrees to sell the above mentioned property to the above named
purchaser(s) on the terms and conditions stated in the above instrument.
City of ebastian
v
Witness
DEED # 468
Rairden;-George'W. and /or
Rairden, Sallie
398 Schuman Drive
Sebastian, Florida
Unit #2 -addn. Block #45 Lots #1 & 16
r e (.0 ciiro�Pxl , i er(�P �3i J 3
/Oy
DEED #468
Cemetety
Paid by 1 dfiliJGK Receipt No. . 2;7.3....... .... Dated.:Auqust. l8, 1981..... George W. Rairden
Sallie Rairden
List Price $$2DO- .OD....... Maximum No. Burial spaces ..2...... .398 Schuman Drive
� bastian, Florida 32958
Discount $ ... 7P7 ........... Total area in square feet t
Net Paid $. 2Q0, OQ........ Monument permitted -F24 -t; .. • • . • • • . • • • • UNIT 2 ADDN. , LOTS 15 & 16, BLK. 45
& R. Issued with deed (Data above this line for City Record only)
4 4VIC
QState of Florida, Departme ` Health and Rehabilitative Services, Vital tics
APPLICATIFOR BURIAL — TRANSIT PERMIT a h
A. (Type or Print)
1. Name of First Middle Last DATE Month Day Year
Deceased George W. Rairden DEATH 03/28/93
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
- Inst - --
3. Name of Medical Medical Examiner Address Phone Number
Certifier 1201 N.W. 16th.St.,Miami Fla.33125
Howard L. Cohen �Phvsician I I -
4. Name of Funeral Home/
Direct Disposer
5. Check
Appro-
priate
Box
Address
1623 North
Fla. Uc.
Number (Area
a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies
this application.
VA Hospital- Miami,Fla.
b ❑R was contacted on within 72
hours after death. He /she verified that this Opath a from natural causes, that there was no accident
nor other external cause of death, and that Ur. ytc o en will complete
and sign the medical certification of cause of death.
c ❑ was contacted on . He /she verified that
, Medical Examiner, will complete and sign the
medical certification.
6• Place of Sebastian Cemetery In state cemetery Removal
Final Disposition: crematory - n e /cownty: Indian River from state Donation
7. Funeral Director/ Signatu F.E. No. /Reg. No. Date Signed
Direct Disposer ,� �N 11r,79 nQ /9a /a i
B.
BURIAL = TRANSIT PERMIT
Permit No. 1223 -93 -0159
Permission is hereby granted to dispose of this body.
❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship
would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director /Direct
Disposer Report" will be filed with the Local Registrar of the County in which death occurred.
❑ No extension of time for filing t eath certificate requested.
Registrar or D Date �.3 Date Certificate
Subregistrar Signature �`�—�� Issued: Due:
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
Signature Medical Examiner Date
or
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
Methods of Disposition: Place of Disposition
E BURIAL ❑ STORAGE Date of Disposition 113 L /,2 '
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton )
or Person-in-Charge)
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 HRS County Public Health Unit in the County where disposition occurred.
HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used)
(Stock Number 5740- 000 - 0326 -2)