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.JUL-18;,2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 P. 003/005
From:The UPS Store 4239 7725899175 07/17/2012 10:56 #500 P.002/007
ED
SEBASTIAN•
arm
• 414111P
HOME OF PELICAN ISLAND
Burial rights in the Sebe0 ian Municipal Cemetery lots/niches purchased by me
AA c \-6k6rS 1 0 h .vl l ittr' 1 APE 5-011.0,-)
(Please print name and address of purchaser) T O 5 1 (3,0 I
(Lot/niche,block, unit description)
are intended for interment of the following individuals:
Please print name(s): i
(1) L.Ook2.W1 V c — r S (6) V;Gi�•�.r'"5 'o)94— (11) Vr Ls-2,5 040--
.
(2) n' i'INCY\a, l dilsee5 (7) ae o-' .e„ �. • 5 (12) 1 vei j4- Vic filers
(3). Vt ( ) SPfrOk VI. S (13) 111Arr. t/ • :e'-5
\ S (14) V.G.)— '--s O)t,
(5) V;(3.-it s ell,- " (10) 6k f !;lk.,1 -er-5 (15)ia-05 Pjol--
interment lots/niches are not to be transferred without written approval of the City of
Sebastian. interrnent'lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
1 h ref 77Z,Gle Date
to day or ZU 1Z by
Subscribed and ew. to herons me this o • has produced• who is personalty krwwn to -me.
�S .. .as ldantirioatlon.p %“tifrrr„
Notary Public.Slate of•Flerida "t'3J `/...4"' STATE . G
1L/ OF \
Names Outwore form i 1 TENNESSEE a
fir . NOTARY
T.;''•. PUBL.IC '
//,,,4rr rGt r ittt ,`.
JUL-18,2012 WED 11 : 15 AM MOB Bristol Highway FAX No. 423 232 5134 P. 004/005
From:The UPS Store 4239 7725899175 07/17/2012 10:56 #500 P.003/007
48
ono
5034iia 0%N
HOME OF PEUCAN ISUND
zi
Burl I rights in the'Sebastian Municipal Cemetery lots/niches purchased by me
;Alit it E 1/,p 4/5 ((1,3- IV ittit.r )4„c . .:r C,rc1 T-1.) 3 '7t j
(Please print name and address of purchaser)
(Lot/niche,block,unit description)
are intended for interment of the following individuals:
Please print name(s):
246 (40-) it i ue-i.e- pi c,-.1.- II iii-) ark-.` if-r, c;&-) P4P 47 Yic.k.z,' pk 4-
(7r6Z) V eKe•-s fa 1,01- SCf,`)- a. sor (" ) Ytc. ..e s p)o4---
4) ')$ III .r5 ,i o,.4- ( , ) .J t x.J-1 Gw) 7)L'') YrctK-L v 5 p1o4--
pfi) qtr yri(-Keys y 04) P a.5 LiAc4) n 9Yr Pci)O+'d a DouglAs fric,g ,
(5 oOc,) ri0 + ' ...' ( . ) ac- `fal k 1 CJ(-u-S )3 t tr't C• V c424,,s U4
Interment lots/niches are not to be transferred without written approval of the City of
Sebastian. Interment lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
I h. F.J.d = •• •e t-' •, ' e terms of this agreement.
Signature Date
ubseibed end swam to before me this }�d,, of Q_� �----. �__ by
�w ..ho 1���_AI[r��i �i�'twwn 4o me, or hoe produced
T O 1-'�j ip"te j - se tdentlyr\ ^ .......
`NvID Pub/a Slots 44�a^— ``�� TAN 6�lio.ii>t∎
Wary �tJ _ gi N -
44 } C
Names of Interred form =y A4 g4,%.;g.
•
JUL-18-2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 F. UUb/Un
From:The UPS Store 4239 7725899175 07/17/2012 10:57 #500 P.004/007
61_,..6
;�anaT jouh�
HOME OF PELICAN ISLAND
Burial rights to the bastion Municipal Cemetery lots/niches purchased by me
,J E� E ,kc '5 165 Tv�146( l,'()E 506)60o C[i1't flJ
(Please print name and address of purchaser)
(Lot/niche,block, unit description)
• are intended for interment of the following individuals:
Please print name(s): /._
t ( ��I) 'Mc�1 QQ Vid 's (P1'(3' itlbJS6n ()M-1-- (11 )
�2,t Y-e-e-c,-
(if j • •c, , - - (7/ n") S n • (12)
c (Th V s C.v- et'S 0-1-- (Wag)) t& )o---' (13)
(rJA L xs�n pi-04 (14)
()54 i C,KPc 5 A . ( ' ) 6-1 1-41 s,) -104- (15)
Interment lots/niches are not to be transferred without written approval of the City of
Sebastian. Interment lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
I have - -d and 4L _ 7 t d the terms of this agreement.
/ - / 7 - I Z--
Signature Date lair-
to berms me This 1 doy of i ' et . by
S{rbscn4b 1ru nd 1 etty m who b persor�0W k . • :6;1. 'ipr his ptodueed
'1�s2 (�L ��14at 1 ntD_c./Lt.S. 9s Identification. .� ". ... .
Notary Public, Is e of _y: -111P;, ;1,-:__
T F •
cn1A" q,QF
Names of Maned form 4'. B�ICY :;i'$.