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.JUL-18,-;2012 WED 1115 AM MOB Bristol H i ghw'ay FAX No 423 232 5134 P. 003/005
From:The UPS Store 4239 7725899175 07/17/2012 10:56 #500 P.002/007
el)
MCI
51314iersilAN
HOME Of PELICAN ISLAND
Burial rights in the Sebe0 ian Municipal Cemetery lots/niches purchased by me
Jvt
(Please print name and address of purchaser) -" 0 '. 1 60 I
(Lot/niche,block, unit description)
are intended for interment of the following individuals:
Please print name(s): p
(1) L (6) , i r s l o-i— (11 ) Vf c;K.:a )a)-•
(2) '(3y hf‘C:rVC�. \i1 ei (7) a Cdr' .e, Vl�- t'5 (12) J Irei-t:61 4 Iicike--s
(3) 0 1 1 t H o-- v'1 c S. -5 (8) B'r`r" ' "c4 - (13) 0,141t1 Vr al r 5
(4) \ 4r'5
(9) (1a) VI'Cl-. )tY
(s) V.JC.Y..-e.c.5 etb1 (10) 631-C:Ag Y7r . r5 (15) 14c1-er o4-
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.
1 h re d u 7fthsagreement•
'T— 17 — 17--
nature Date
o� tn4 erey 01 _ 2� t22 by
Subscribed 1.(5,t before me this
{` who le personaly known io me, or halt produced
Nolary Public.slats o(•Flbrtda -r `�,:.?'P•/ STATE... '.,<;.
t1am.s of Wowed form ' 2 i TENNESSEE
Y it is NOTARY l
T'•. PUBLIC.,' .1
//'''hr►rinrii`�,``
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
oP
ono
. HOME Of PELICAN ISlAN0
Buri I rights in the,Sf bastion Municipal Cemetery lots/niches purchased by me /,�
'C\44 it E. I 1 Qc/LC(5 (C.5- -V t Cr ) .. 6. e,-_I TO 3 7 W
(Please print name and address of purchaser)
(Lot/niche,block,unit description)
are intended for interment of the following Individuals:
Please print name(s):
9 6 a-) l i c_gL p i o-i- (16 c i) Sre-.t L c 76P 47--) Vic .e s p e,4-
l/r 6 T) ei=-e.,s fD k i 7) .a-)-> a l-. ,)s,dr) ("c6:1") 1r I C....e.S p)&--
(Or) C() iti c..a.+r°a r 10.1- (f)(.J,3-) t`kA-i f cry 7)(2 ) Y roues 1)104_
pi) 3) -oa, V(IGKers )4&l) f-4-1.5 l..fx., .gin (Y' ( cf)tilr Ttibueilas (ic*..t,
l9'06) -oeg,- V ICY-Crs (7K k,-) 1 i \ it -rS (t )3LE1&rt C V;C.424r$ l)+Z
Interment lotslniches 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 e stems of this agreement.
Signature Date
ubseRbed and swan to before Me;Ito. day of r by
own me. or Aae produced
•
Nary Public,data cf$Ie lda i 4 OPk ;'n_N N OF ; C
.
Names of Interred town = A TQ S 4.
;g.
''...
JUL-18-2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 F UU5/UU5
From:The UPS Store 4239 7725899175 07117/2012 10:57 #500 P.004/007
6-.t )
otra
SEBASTIAN
462Iiiii
NOME OF PELICAN ISLAND
Burial rights in the bastion Municipal Cemetery lots/niches purchased by me
n ,cLEI E (cif 1r 165" T 'd(6( 1 E 1 Tr-)
(Please print name and address of purchaser)
Esc- St 't\cc ' or,-,4- I
(Lot/niche.block. unit description)
are intended for interment of the following individuals:
Please print name(s):
-4 ( • 1 on•i - ;tiers (• 3(A , • 1 4- (11 )
.411( 'C.. ' �-.i- (7f' 1,7 S II- , (12)
) 33 V►c1/---efs w.
( ' a: i $zn a - , (13)
r
criA 104' (14)
(' 'I NItCY e 5 lbt-' 201 646)LF11-L%Sf° �?
/ -I- (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.
/ -7 - / 7 - / 2._._
Signature Date
s fi to before me Ih l day er�1� �'d by
�S��C�1au 31,E who le personally k alt ,ipt has produced
ty2 CJtr t nib.(p'lt,r 3, as ldentifrostloa "S,?.'''-.6.)>,
Notary Public,Slate of cleiida -[")3 _ *I N Np, C
- (xnt ,o`rq,Q 6F ::�
Names of IM.nee(en.. 2°., 6</Cl' j'Po