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JUL-182012 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
ED
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HOME OF PELICAN ISLAND
Burial rights In the Sebas}ian Municipal Cemetery lots/niches purchased by me
tc A c V\-4;k6t's 1 (9h -fvt,4r lAPt= 570t1,4opCIIT
(Please print name and address of purchaser) T f-9 '' 1 60 l
(Lot/niche,block, unit description)
are intended for interment of the following Individuals:
Please print name(s):
(1) .ou�_r� ��G t �5 (6) V,.Li.2.r5 pivi
(11 ) liiC -@ pu-
(2) C3' t ns,i.ck, i OA.PYS (7) Ul.•eOr- •c •C.. • . S (12) /1 Iref-e4 4 itiCi ei—s
(13) w►tt tl"
(3)• �.c'c1 on C�-- �/'1 Gi4.•z.r'`S (a) PfY`(� � c�k4r'S � '�i ' � S
\ (14) t/,c -e. O)n4-•
(5) yi( .-trs F1bA"" (10) 61414-14A PCk.p,- (15) ;cl-pi pInT'
Interment lots/niches are not to be transferred without written approval of the City of
Sebastian. Interrnent'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 to a ems of this agreement.
• i--- 17 12--
nature Date
^ day or ZU 1Z b
Subscribtn VL ofi+ before me this ( . has produced
�` ��R�,v�' who b psrsonaly knaWn 10 �me,
bt-. (�'C�lDtere 'Zti 1s IQsntitioalion. ```�‘‘�p.LE7 j•'II
No b.State oS. Ierida '[' �`, '/ STATE -.r
Names of intoned form ' i° TENNESSEE
. *\ NOTARY 1
�''. PUBLIC ..y.:-
.
„,Ftrtnnio.
JUL-18r2012 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
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ova
416011P
. NOME OF PELICAN ISLAND
Burl 1 rights in the,Sebastian Municipal Cemetery lots/niches purchased by me
/�;G 4 U ejielr5 (CT -j j er )4uc . . , C, (-I T13 3 7M
(Please print name and address of purchaser)
(Lot/niche,block,unit description)
are intended for interment of the following individuals:
Please print name(s):
246 W-) 11 i r L pioa— (14 61) :r --.t IA 1,;&1 P4P45") Yit-g-e' 004--
(7f G 2) Vie,-ers fa),�-i- (7)(2,1)- c o,. so.n (76a-7 Y 1 ck...e s p)04--
Pr) C() 11 c a.r °i G (1ie)(,,3-)'rJA- cn 7)Cam) V rcii,t.-s pIo4--
P'') .9) --Der- V1‘c-leers y4.6 47 PWI� IdoLosorN Vr 447 a IJbv11As t1"ic•k 4r
l s 010 —to ` +r• ' ,... (1 ) "" ,\ A C rY S c/ )alttailtr? c v;c4.2.x.�use.
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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 d e e terms of this agreement,
—7 -1 -2 --lZ
Signature Date
t��aY of 1) by
ubseribbed smi s before, ma this `` � o�'; me, o► ham prtiducad
T ML, [�"aa, it 00"N as ldanli (e. T,,
Notary Public,State oi$Jarida -ci _9 HOMES i C
Names of Interred to ' A4 P,4 64.r -
-*--,'1'0,..'1, ....e4/�y .A"'
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''/��..t►.r I I u t c`���,`
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
63)
ono
SEBAgnAN
441VA°
HOME OF PELICAN IAAND
Burial rights in the S bastion Municipal Cemetery lots/niches purchased by me
� EI E J(L '5 16s T''d'6' 1,0,F yQ(nkk,a c5cc Ti?
(Please print name and address of purchaser)
1_,o 3 t -Is 5 0A-,--k- I
(Lot/niche,block, unit description)
•
are intended for interment of the following Individuals:
Please print name(s):
(• 3t ! (11 )
r I �r'c�n.ti • ;c1zei-5 i.� t 1 -�—
r > ' .c, • - ,,A__. (7/ $"7 S n . (12)
V (_ 3) V f C.IL2r6 ml o-1- (T)e ,a) (.1%1,oszel 1 0 1 D4_, (13)
(yiA L S r 4p104 (14)
V) t )4- (5 • 4 ( ; ) 643 LPJwS) •10-1- (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 terns of this agreement.
. -7 - / 7 - / Z_
Signature Date
U to berms me this � dny of�� �,; �• by
8}� cna14►� kp (tyt lief has produced
l`e �4 who is personalty
as tdentikation »...",•.•F� %
�s� qtr t st��t a'Ltt'.s- 3T
Notary Publb.Slate --- c-eta `- Ii..4 6/14.':'i
yI`AGrq FF��•
Mamas of Intense taw. � ti•, e4/C e
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