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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
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HOME OF PELICAN ISLAND
Burial rights in the Sebes
! vt }ian Municipal Cemetery lots/niches purchased by me
tG6t1 t V,e.k6e- to; . 4,t.htr l pp tx Soli, oi..i c
(Please print name and address of purchaser) 't P ` 60 I
(Lot/niche,block, unit description)
are intended for interment of the following individuals:
Please print name(s):
(1) LCX>e yG a.$-s (6) 11;C. 2l5 plo4i— (1 ) Viii:- -(2..-- p)al
-
(2) a t-ns,f,.c i4ee5 (7) aece- .Z - .. . s (12) L77re.c.e.E4- ici er5
'1 Ckce_-5 (8) `r-'"a ' �[ [/ QYs (13) Art.1 VI(..)K ZJ"5
3)Y (�1=c�pll Cam- i
(14) t/i'C1i—e. rhul
(5) Y L .-$Le5 et; --- (10) Aven Valk- r5 (15) 11,-c„pi-5 131.1-
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.
t h re d u !a a arms of this agreement.
G I, 17 12--
nature Date
tndrti day or ZO t?! by
Subscribed and ew. to beano mwhothks personalty known - hay produced
V tn••_ qtr U »�,,,rrr
N identification. ``\``.``ALET� 'f.,/,.
Nolary Public.Slate of•Fbride "T).1 `F'r STATE •:�<'
�'i• OF s
Noma'of Wired form _ 1 TENNESSEE B
it NOTARY l
W• PUBLIC , '
,'1jrrr,.... ,
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
1 6:2/
Diva
iP
. NOME OF PELICAN ISLAND
Burl I ripphts in the Sr bastion Municipal Cemetery lots/niches purchased by me
■C6 it Ue o4!ie✓5` ((u S' (Cc.jt'cr )410E, . �1u C, 113 LP
(1 � 3 7 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): �,/
946W� 1/ic.iL7 -'5 ptof 61) S,r&t ( / P` )?w7) Yic..i •z- Fio4-
r$6 ?) Vie -eys (a),>✓-t-- (/)&.57- v, sk=.n vyfb)-5) V t Ck-e. p)04---
) •18 Y'e i ..4- c/) ?5 r,.ra-Le x c.� .)(3 ) Vr(Jl&L 5 eI0.[--
t � I S �
Y 0 1> ye.‘c.-Ker.S Q`a ? -1'S LFX..: r1 t 0190-0,8 e Uzw ei 1 a S SIB c.*A
(5)/OD ! b e- V IL r (pc(' \ to -Y5 7I36)314-Piltr) C V;C^F2`Q'-5 �e.
Interment lots/niches are not to be transferred without written approval of the City of
Sebastian. Interment lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
I h d
7tetemofth1s agreement.
-7 -1 -2 --1Z
Signature Date
ubseribed and swan n before me this -`day or t{i_. �' r by
�,�� !i,,khown me, or Ass produced
i
es IdenliltpD ..... �t`j.',,
Nolary Public,Slate o1$Ja4da �cJ y A I �V, 0' ',C
Names of)nterre0 town 2 AV T,gR64.
",,1;l!I►niiut,%'�'�•
JUL-18;2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 F. UU5/UV
From:The UPS Store 4239 7725899175 07/1712012 10:57 #500 P.004/007
0
arra
NOME OF PELICAN ISLAND
Cemetery lots/niches purchased by me
bastion Municipal
Burial rights in th e b el
/)��,iim E (cilce5 165 -ritew liopE 50 ina6od CiN h2
(Please print name and address of purchaser)
L r St 'btx. 8' or6+ 1
(Lot/niche,block, unit description)
are intended for interment of the following Individuals:
Please print name(s):
_t ( a I ro.1 • ; (. 31at tt.),,, . 4 .-�- (ii )
cJze�-5
( 'c., - a-v- (7/ ..) St % (12)
real (33.--) Vi(.1/---e.-5 0 o1-- (,4( LPI Sv+'1 p (13)
( ) (2:1'4)YA GKstr' p!011— (y10) Lou.Ason 10104' (14)
(, ( 5...) Nit c r- rs c it> 901 646)L.At`'3-'1°10 (16)
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 nd t d the terms of this agreement.
Signature nature Date
1�(�4`Jr th Y. to Worn mwho lhl is p.rsotdayk` ` .1..,`_ ',,or hns�p�oduced
t&LD t awl S. as Identification_ �'� ,�` .i
qT'
rF R .-n.
Notary Pu' t*or Florida �(z _ 9 l��'N c
Names of IMane4 f % +94/ .,Po
'1 oils moo°