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,JUL-16,,,2012 WED 11 : 15 AM MOB 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
seasi wl A ena
HOME OF PELICAN ISLAND
Burial tights In the Sebastian Municipal Cemetery lots/niches purchased by me
(Please print name and address of purchaser) -r f 1 60 1
(Lot/niche,block, unit description)
are intended for interment of the following Individuals:
Please print name(s):
(1) Lox_e_\11 (6) ;G1Z.2,r'S picric (11 ) Via p)o)-
(2) (J' 1-110(ck. I er S (7) at?Ce- .6 "�.. . (12) I Irei-.Gtr- V ciP€1 S
(3) 1 (t-L`c)Ono- \'i c-Ac..r`y (8) B'" )1 ' [ i c*-eY5S % C• .tr-`j
(4) (9) (14) v�L.N-e. (1 n4--
�cam-- �{ i {�zY'��
(5) 1,(3-11.r5-11.r•S et >-\- (10) 6i i' •1 Pr3fr-W5 (15)3c r'5 rib4
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 r® d u to a arms of this agreement.
nature Date n
1nL2/— day or _• 'ZG�( by
Subs INA.3 U , ; to before. w this 44o
S who 1e personalty known me, or Aes produced
as IdantitmOlon. `.�`N��PLEr��,''.
Nola Public,slate oi•Fiedds "ty� ``,L'rP�STATE TF
Moistly ..\.,
4:f� OF
mamas of mimeo form _ 2 j TENNESSEE i v=
�
1r : NOTARY /
\. PUBLIC ,
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i;. i ;C ``%``III
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
' (;; /
•
Os no
N
, 4 i a I i P
NOME OF PELICAN Isurm
Burl I rights in the'Spbastian Municipal Cemetery lots/niches purchased by me
/ Uct E. U;chci(5 (‘5" (vAr )00c . . , e, 9 TO 3 7M
(Please print name and address of purchaser)
Lam- 5z, 4•..31 1!:)``o c.. . 93 0(:1-.\- I
(Lot/niche,block,unit description)
are intended for interment of the following individuals:
Please print name(s):
ve)6 (p iiicK11. d'1 I'§I) I -' tI, !�r-,y c;& )P w7) 1ic.k.z - ptD4--
r G Mt Cid e,5 fa 4,-(-- 06. 7- o.. sts•r) 91f63-1) i t c,k.e.rs p)ty4--
P) )e Ili .r`› ,I c.'4-- ( ) j r -1..fw6c+t ) Vic p104—
YI Cg) l)Cn ‘(.1GKers y46.6'D f)v-Is Lax. » (t Pcfi • cu ei IAs U i<.„,
(9 ?c)"-‘� r V;c r Ao.--3) einisi\ 0 e. 0-5 (A-` ) nhk-) c V,c+24r5 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. = -l-.d = •• •e t4b•, ` e terms of this agreement,-7 —t-.7 —I 7.—
Ard,..A_ .Signature Date
ubserbed and sworn to before me this day of 1?` y
who ��� �? !�iknown me. or • has produced
R5p'1 t
as idanli&Ikei. .....,. ,4T�.
•
Nalary Public,State otFJo lds ,, ;4: 4 o, F °c,,7.
i NTFS ic-
Names of Interred form N' Ao•9R 4. +,Z
''fiisii11111"
JUL-18;2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 F. UUb/UU5
From:The UPS Store 4239 7725899175 07/17/2012 10:57 #500 P.004/007
(. )
SEBASTIAN oaa
46MISP
HOME OF PELICAN ISLAND
Burial rights in the bastion Municipal Cemetery lots/niches purchased by me
, EI C (cci5 165- rZ'd( 1 yo irJ600 e rr ct Tr-)
(Please print name and address of purchaser)
1..oSr 31 -.1 c. a 0r,`r+ 1
(Lot/niche,block, unit description)
are intended for interment of the following Individuals:
Please print name(s):
* r34`6 1)- rOr,4� �f;cuer-s (KY(34A 1, ;sn ()to 4— (11 )
( 'C.. • a-�- (7/ ;,-.) a n , (12)
Y"' �..�3T V i Cie--er.S a„,..,_ 'A) sv,'1 1('i ) (13)
(riel t.. .). ar1 ,fJkJ" (14)
(F ( Ytc - 5 ciol- ( 643.L-PIt s Pk 4- (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.
- 17 - / z—.
Signature Date 7,�.
S� q to before me this ! day ef�r� y ---� by
`P4�1C1/1au I4� , who Is personalty It • • oil,l/pr has produced
\o.„1 M. t alb t encl. as IdeNificatloa r'""S;" F)�
\Mn��-,4.(Ilr._ C3 " ± *i j•cN OpTF -n
Notary Public,Stste of Merida �'� C=
I FFnn
Nr `OTC FF A:z:
Hams*a Keeled form y% eV 1'
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