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JUL-18 2012 WED 1 115 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
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ona
. 4a1100
HOME OF PELICAN ISLAND
Burial rights In the Sebastian Municipal Cemetery lots/niches purchased by me ��
OrtA=\ t I�;�i<6rs IV,- ./ vl.(St r I pp �-011,01./d
(Please print name and address of purchaser) -r' ti -4 1 60 I
(Lot/niche,block, unit description)
I
are intended for interment of the following Individuals:
Please print name(s):
(,) L (6) ,wit er' ,o10-1- (11 ) tftc t:e.rs )4.0-
(2) ?lay 1„,e. r.-k. \Ii Pry (7) a Cr"3.e., V r }'.5 (12) 1�heft..' Vlcii4e-s
(8) SFrrt}1) V I C*-QJr5 (13) R,wr••-( 0(AU-5
(4)Apr c V i Citd" •er.5 (9) (14) t/i.c.. -Q.,."y eh:4_,
(5) V1 C.,:..Q/ s e t b (10) C itto62 A Y)44-i2F,j' (15)/c - i"t r1 -
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 re d u tFl a arms of this agreement.
fr7--- 17 - 12--.
nature Date
Subscribed V to before mwhoth1Is personalty day of 10 'rte, or has produced
I Q �L! .` b!Identification. `\``'c" p.LE T j��"i�'i
4‘110,914N4_,. ..�4.13-94/1/4.— ; P.:... .... .
Notary Public.State of•Weride -na ti�'r• STATE: :t..
/• OF
Nome of Intoned fore, i. ir TENNESSEE•_�p=
>x t NOTARY J it
S '•. PUBLIC.,,'
i,.rhr1nN0-
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
Al
ona
416=11P
HOME OF PEUCAN IslAND
Burl I rights in the'Sabastian Municipal Cemetery lots/niches purchased by me
;G vb 4 E. U e pRe✓5 (6 S" -rodiv )0,,c- . . C, (-( T73 3 7W 1
(Please print name and address of purchaser)
LA- 5O c& .)`i -1 0,C-. % u(;,--\-
(Lot/niche,block,unit description)
are intended for interment of the following individuals:
Please print name(s): `",�
94 6 w� iticiat pio.i-- t� I
g1) ' -' t ! v.-4.&.) Y' Pw7Yic.k•z•s pio4-
(14.G ")) Viod-eis 0,n-i- (7)(?, -)Ac r ., so-r) c7(.).17 Yick-ens p)o4---
i 0 i Ili .r et G.4-- (f)j,2�) , -Vic..-ti 7)62) Vrc.r LeS e1o4--
X 0) i)cr ■(1GQJrS /6 4) tl)'i''J )ts "‘ V� PO D. Uzwei IAS (1 iGk-Er
(90- )-Let) V IC-�Cr-S (711--0J7) i\ i C- -o S (7 (36) nht-) c V;C}.Z•2.r$ lSQ
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 e e terms of this agreement,
--7 -( '-z --!?-
Signature Date -ick-ubseribsd and swan to before me lhi: day of ku. _._._• by
`$ t b-w • me ito t�re�� ��,�known me, or has produced
T lJL c*,al�QSP if o 3 as lelanlittik (i'f•+^ •(fit•'.
Nulary Public.Slaty olEJarieia r � HNj�4 i-
Natna6 of Interred form y':A��.Q��E'F i
yc•. B</c .,. "'c
JUL-18;2012 WED 11 : 15 AM MCB Bristol Highway FAX No. 423 232 5134 F. UU5/Un
From:The UPS Store 4239 7725899175 07/17/2012 10:57 #500 P.004/007
(.7; )
ova
SEBASTIAN
46211a1
HOME OF PELICAN r$LAND
Burial rights in the Sebastian Municipal Cemetery lots/niches purchased by me
�c E V 1cc5 165- T+'t,ucr r'(F 5-01,10600 C[i ( - i
(Please print name and address of purchaser)
(Lot/niche.block, unit description)
are intended for interment of the following individuals:
Please print name(s):
-4' (3/(i) or, et V;ci -s ( '(3', 1 3Sc n pkJ (11 )
( .7 •c.. • 6.4- (7/ .") s a- (12)
V) (- 3---) V i C.1--er5 61_o1-- (r'( ) 6°01.s5v, p),,.4... (13)
(/) ( 2=`1)YAGK•r.rr p i'o4_. (1' ( plvk (14)
(7 ( ) Nit�KP5 1t, (EJ (13)L.pjt`'scielo"- (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.
Signature Date
This ______ et�� 1 - by wit Dsenbsd nd berors me i. r has produced
s' tC.�1��, who Is personalty
O CI L. Qg S stl!_t p'll..S. as klaatificabon. Q� :
l * s 4F�` i
Mn r al 4r a)-52"1". 1i 0.1?
Notary Public,Sme of rleida [ = : N` a
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Names of Wooed fete► e�C�'
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