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SEBASTIAN MUNICIPAL CEMETERY
TRANSFER OF INTEREST IN BURIAL RIGHTS
CONSENT FORM
�o0p�
jWe, 1S fEa�c FLaft' , Grantee(s) of City of Sebastian
Cemetery Deed # or City of Sebastian Cemetery Certificate No. , do hereby transfer my /our
interest in the following:
Lot(s) /Niche(s)J ", Blocky Unit of the Sebastian Municipal Cemetery
to: 4oF
,�Z:z:j-C G s`�l S'f� ✓Fflo f3.�.9c.� fl . 30 167'
in accordance with Section 34 -13 of the Code of Ordinances of the City of Sebastian which states:
"Sec. 34 -13. Sale of interment sites.
No interment site owner shall allow interments in their interment sites for a remuneration, nor
shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall
be bought or sold for speculation.
I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of
Sebastian.
8igInaturlb of Original Grantee
Signature of Original Grantee
State of
County
Before
i this�day ,personally appeared L and
known to me or who picIdubed as
who ackndged to me that he /she /they executed the same for the u s and purposes herein get
The City, of Se of
recy1n r
By:
Ap
Rich Stringer, City
Printed Name:
My Commission Expires: a
Notary Stamp:
in hereby consents to the transfer of burial rig
nce with Section 34 -13 of the City of Sebastiai
w
,• Al:- Mii►n-eT
and Legal Sufficiency:
ATTEST: ` -14G
Sally A. M
WRIIIPMarch 18, 2006
aWed Thtu Notary Pubhc undernAtm
- City Clerk
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