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Date of Burial
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Paid by General Receipt No. ...72 NOV 17 , 1976
........ .... Dated ..............................
East Price $ * *20D.00A* .. .
Maximum No. Burial spaces ..... 2. , , . , ,
Discount $........7....... Total area in square feet
................
Net Paid $ * *2QQ100 **
• • • • . Monument permitted
R&R attached (Data above this line for City Record only)
DEED #302
Mrs. Hugh (Eleanor) GuW ;
*rth Central
Roat6FIr- -Box T08-7-
Sebastian (Roseland)
(North of Cemetery, south
of Roseland Road)
LOTS 4 & 5, BLOCK 1 UNIT #2
GUY, Mrs. Hugh (Eleanor) Deed # 302
Rt. 1, Box 108
No. Central Ave.
Sebastian
(in Roseland, North of Cemetery and South of Roseland Rd.)
Block 1, lots ,&and X55,, Unit 2.
Hugh Guy interred, lot, 11118176.
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Ju' -17 -99 09:20A CABOT FUNERAL HOME*
STATE OF ARKANSAS
ORIGINAL
501 B43 2936 P -05
Arkansas Department of Health
Division of vital Records
BURIAL- TRANSIT /DISINTERMENT PERMIT
r�l•ttti t No. - - - -.
Always comp left/ Ibis sec`tichl" C J( f
Fall name of dwM." . ea R 0 _ GH 8 Thy f
Death-
of � Plucat .__.,
(loth, ooms r. K; Ate- -� _
this
0
Final Disposition. 01r i J o• - IS"I"L Sl�euS caw trRe y liL�n R11IA.r� F L
rAM+ 'T tiurFaL crvoatiun, ttallwt, atntraan, rra) Kkmewry or MMlat(47! K'ouJJ ! (tjufai
Funeral dirw-tor e. k f►a.l CAi 1�,� License No. -113165 Addre or—C.&I-VE
_.. PEMT -
Permission is hereby given .... _
to M,', rr ,Ae C#,1 �_.. _...— Li(smfw No. _ to disPOW of the haiv as Alouvo stated.
(EfaEal"tor. fu*aRl direrw. or Person aeons am mW
Dated at 40 ria kW& tAr ku a. i a r —this- I i� day of - _.... 19.
(ttrBiamesaaWnm) D f�
lRnKiaratl
CEMETERY OR CREMATORY AUTHORITY SHALL FILL OLT THE SPACE BELOW
Body WA ,A ,oin� , � lh � in Sebastian Cemetery
f9taM vMrnr rnnrwL dunw� stand. sae.! lCemea�ry rn ('rwauxsl
Place Sebastian, Florida.. Signature
,. IcLk" ... MAW) 1•Y!e n. pnrnn ie rAae�pr)_—
013INTERMENT SECTION. (Ca "I s this section if ap pl Ing fora disintsrmsn_t psrmiU
Proem Piece of Burial (Man* Addreaa
Pleceot pemte rmeet (Namal r At10roH
Date of Dlalnteramt nets at nemprmenl -• - _. _.
Name fn Funeral Home AGGt9e9
S to local Raq +Sara, ar (aputy _ Dale
SEE OTHFH SIDE -This permit =61. br encion;ed by the Sextan (or by she Funeral DirvLtor where there is no Sexton) and retllrnwi within
10 days to the Registrar of the district in which dialtosition sakes p4•uv.-