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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 PEUCAN ISLAND
Burial rights In the Sebes Ian Municipal Cemetery lots/niches purchased by me
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tr,6t=, t \Gt<E(S 1 (9 h - vdit;r JAPE= 3 t oi.'c±:r 1
(Please print name and address oT purchaser) -( 0 Z 60 I
(Lot/niche,block, unit description)
are intended for interment of the following individuals:
Please print name(s):
(1) E.. (6) V; p)04- (11 ) Vic iner )o)•-
(2) r3' linen . I Lik.ers (7) aecy- •e, '�. ' • (12) 1..Key-el-4- Vic fke s
(3) lOfto-- Vi(K.•e.-5 (8) JPIrt}.') It(i.c 4Y5_ (13) 1+kwnz.--{ V I OgAr 5
(4)A-Pr cam-- Vi v\14Yr.5 (9)
(14) Vic1_e• tot_
(5) ,tY-Ar S t (10) , .i ,, V7c.ik- ' (15) ci:49'45 p io
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 to e arms of this agreement.
'' /7 - 12--
nature Date
n day or ZU lZ t,
eubsc11b1nsd and V • to before me this i e, or ' has
produced
who le personalty known to �me,
•sldantirioetlon. ��»�ilrrrrr�
•
Nolary Public.State of•Plerioa "rya f �v� STATE '',
Nam.s of Intoned forgo / OF 2• TENNESSEE
NOTARY l
\. PUBLIC.y.....:
JUL-18,2012 WED 11 : 15 AM MCB 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
one
SIB IAN
NOME of PE11UN IsuND
Burl I rights in the Sebastian Municipal Cemetery lots/niches purchased by me
;c1(14 ljr cie(5 Twifer )o„e . 1-1-.00 C. 773 3 W/
(Please print name and address of purchaser)
Lam- o d-..31 Flo a Or\-14- 1
(Lot/niche,block,unit description)
are intended for interment of the following individuals:
Please print name(s):
rX6 (1 iiietz� .� — (61) a'-&.t JJr-, o P4P`P--) a4--
($P G V;e -ers 4 k1-i-- (7> i7- a... so=n cy �I) V t c k p i--
pi) 1$ V Y'.Q r •i e ( ' i j r,-rte- cry, 7)Cam) 1(Pote-ces et 04-
o69) 1 kt.k errs $%&J) PWi5 l..fxa`n VC 4)7)00'8 a ubu /As
(962c)r�1 e9 `it V r c, ,r'S (76,106) ePrs. L lJ & S (� 36)Skoh ri V;c42 ,5 Ue.
Interment lots/niches are not to be transferred without written approval of the City of
Sebastian. Interment lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
I h= = x.d = •• u •e t4h•, e terms of this agreement.
Signature Date
ubsegbed and swan n before me this day of by
S - ��� j ,,��known me, or he pi p oduced
T ... [ -�l�t� j t p'�y>~as iden it∎tik fo ....... �F�,
tt(AOCAN,-.Q�1� .a-o — , 411�F•. rb•)e%
Notary Pubic,$tab o1E eMe _>i NONF C
Names of Interred teen A&P•qn-4.i
141% rfk 1
• .•
JUL-18}2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 F. UUS/UU5
From:The UPS Store 4239 7725899175 07/17/2012 10:57 #500 P.004/007
• 6-.. )
ona
SEBASTIAN
4allIP
• HOME OF PELICAN ISLAND
Burial rights in the bastian Municipal Cemetery lots/niches purchased by me
t iE� E (A 5 165- Tr)Lk( r)4d r yQ lev)60 0 c fit( Tp
(Please print name and address of purchaser)
use- 3 t 8' 0n`,-4- I
(Lot/niche.block. unit description)
are intended for interment of the following Individuals:
Please print name(s):
.4 (.14/6(-1 -c , t Vide4.k-s ( '(31 L :sr, ej,4._ (11 )
vf (5) U;a,e..r5 42k;4- (T/( '.7 ) 6. u)scp .Srj- (12)
(43Th Vi c.r-.ems 0_o4_ (94( .a) L see, in) -- (13)
(.4 (2)4)\AC-V4.r 5 p1 p4--- (Y(' )t 14-1to sN, p104' (14)
(l64 (. VtcY--er5 n`oi--' 901 646)L,Flu% ieJo4- (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 nd t d the terms of this agreement.
/ 7 - / 7 - / Z-
Signature Date ��;;.�
b balers the This ` dBy ar�� t ,.__„__ by Lot 8titettR�rulnd who ie personnUy k .. ,,,of has pmducad
solary Public. y . N0?-00 'r
% NtA l�F �. -
Namas o{Intone*form L� CY r►1
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