HomeMy WebLinkAbout2-13-11SHEET NO.
TERMS
RATING
CREDIT LIMIT
Block 20 hots Unit 1 O.A.
a /k /a SW4 Lot 3
Revels, Alfred LeRoy interred 8/1/89 - Lot 12,B1k.13,Un2
Revels, Sadie 11 4/24/81 " 11 it
G
ti
' Block 13 LO t Unit 2
40 � P&. 716191
Deed # 0- 7 ,,4LL14
W 5Y
D. J. Revels
Rt. 1, Box 105
Old Dixie Hwy
Sebastian
Sadie Revels (daughter -in -law) interred 4 -24 -81 Lot lfl
�Alfred L. Revels of 18,.,/.1/89 - Lot 12)
�rQ.1J.�a►P.�STt�ir'�� ,�� i��cr '�o?��U /�flp ,�..�i�- /I .-�-
#185. $50.00 4123180
Cemetery 197 50.00 6118180
Paid by (Met -1 Receipt No . ............. .... Dated...... /. 00 . C p te)
List Price $. **100.00• * *„ Maximum No. Burial
spaces ..l .........
Discount $ ...... •, Total area in square feet
................
Net Paid $. , *1.0.0.00.**
Monument permitted .. FZ a t.. _ _ . _ _
' R (Data above this line for City Record only)
Deed # 41
D. J. Revels
Rt. 1, Bost 105
01d Dixie Hwy, Seb.
Blk 13, Loft 11, Unit
r)
Name
Unit
Block I Z
Lot
Date of Mark-out
-
Date of Burial Time
Name of Funeral Horn
N0.
RECEIVED FROM
LARS
y
Account Total $ J
Amount Paid $ 0 0
Balance oue $ 00
"THE EFFICIENCYSLINE-AN AMPAV PRODUCT
760- 0
i
i �00 Do
Few
i
ipwG
14
eo
August 21, 1980
Mr. D. J. Revels
OId Dixie Highway
Sebastian, Florida 32958
Dear Mr. Revels:
On April 23, 1980 you deposited $50.00 toward.the- purchase of
four cemetery lots In Block 13, unit 2 of the.Sebastian.Cemetery.
At that time you agreed to pay $50.00 each month until the total
of $400.00 was paid in full.-You made -one payment on June 38.
To date you have paid $100.00
leaving a balance,of $300.00
we have not beard from you and are checking to see.if you are still
Interested In purchasing these lots as we need to finalize the
paperwork on this matter beforethe,end of the fiscal year on
October 1, 1980.
Please let us hear from gou.
EAR /rj
1
.very truly yours,
R1lzabeth A. Reid
,Acting City Clerk
STATE OF FLORIDA --
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL- TRANSIT PERMIT
NAME OF
First
Middle Last
DATE Month Day Year
D
ype or print)
SAD I E
LOUISE REVELS
DEATH April
PLACE OF DEATH
CITY, TOWN, OR LOCATION
NAME OF llf not in hospital, give street address)
COUNTY
HOSPITAL OR
I
Indian
River
Vero Beach
INSTITUTION
Attending PhysicionAg
(Name of Medical Certifier)
(Address)
Medical Examiners 0
Victor Rodriguez, M.D.. 2300 Sth
Avenue..Vero
rH,, uneral
(Name)
(Address)
Floyd/Strunk
Funeral Home. , 24 14th Avenue—Vero
Beach.
Check A ❑ A completed certificate of death accompanies this application.
One
Funeral
Di rectol
B Qx Dr- Rodr i g-e- was contacted on APRIL 23, , 19-9-1.
He has assured me that this death was from natural causes and that he will complete and sign
the medical certification of cause of death.
C ❑ The attending physician was unavailable or this death comes within the Medical Examiners
jurisdiction. The body was released to me by
on , 19 .
(Fla. Lie. No.)
(Date Signed)
ADril 23. 1981
BURIAL TRANSIT PERMIT Permit o 130 -890
Permission is hereby granted to dispose of this body by burial, transportation out of state, storage or cremation. For
cremation a waiting period of 48 hours after death must be observed and the Medical Examiner's approval must
also be obtained.
A five day extension of time for filing the death certificate has been requested and granted.
Signature of �` Date
Registra . 1&-fu 9 C &` X � 4,11 �. /J -k(' G�.' J Issued ADr i 1 21- 1981,
Method of Disposition
BURIAL
❑ CREMATION
❑ STORAGE
❑ OTHER (Specify)
Signature of Sexton
CEMETERY OR CREMATORY
Date of
Disposition
Place of
Disposition
or Person in Charge�i�
This permit must be endorsed by the sexton or person in charge (or by the funeral director when there is no sexton)
and returned within 10 days to the local county health department.
MRS Form 326 (1/77)