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Home My WebLink About4-02-05Name r� CA Y"\ Unit Block Lot Date of Mark -out Date of Burial -5 1 Name of Furneral Home 5 t Authorized by 7c I Vero Beach Crematory, LLC 1830 Wilbur Avenue Vero Beach, Florida 32960 We hereby certify that these are the cremated human remains of. - William Edward Keesee April 22, 2024 (Date of Death) Strunk Funeral Homes & Crematory (Funeral Home in Charge) 8216 (Cremation ID Number) April 29, 2024 (Date of Cremation) Sebastian, Florida (City and State) By: J ` (Cremator Signature) FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Joseph Vergnaud, Cemetery Sexton Sebastian Municipal Cemetery Phone: (772) 589-2545 Fax: (772) 228-9927 Jveranaud(&citvofsebastian. orq City Clerk's Office — Cathy Testa City Hall, 1225 Main Street, Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 ctesta(a)citvofsebastian.orq FUNERAL HOME: Strunk Funeral Homes & Crematory ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE#: 772-589-1000 (Check One) XXXX OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE Lot 5 Block 2 Unit 4 Lot Block Unit Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: 10:00 AM — Sat., May 11, 2024 Committal Service / Cremains DECEASED NAME: William Edward Keesee Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Sandra Keesee -'sav"Mra Luesee 4/29/2024 Name Signature Date 3966 62nd Avenue, Vero Beach, Florida, 32966 I certify that I have determined the ownership of the above described site that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: Kris McDaniel Name I:11 &Md2av" Signature 4/29/2024 Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: ;y.,yse 04/29/2024 met6ry Sextot( Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. CITY OF SEBASTIAN 15757 ADMINISTRATIVE SERVICES RECEIPT C Name ❑ Cash q Date 5'/j I a7 ❑ Check # �t L01111F4M VG-C-5F, ❑Credit SQI21i ICi✓ • 5- II --AQ4 Amount Paid 001501 362150 Non -Taxable Rent 001001 220000 Security Deposit 001501 362100 Taxable Rent 001001 208001 Sales Tax 450010 369900 Airport Badge 450010 362521 AP Shade Hangar Rent 450001 208045 Airport Sales Tax 001501 347557 Community Center Revenue 001501 341920 General Fund Copies 001501 354100 Code Enforcement Fines 001001 220030 PD Shop with a Cop 001001220033 PD COPE 001001 220032 PD Explorer 010043 535270 PO Uniforms 601010 343800 Cemetery Lot Sales 001501 343805 Cemetery FeesJO. 480010 341920 Bldg Dept Copies k.�iCCL a Lois , Total sa 4gt ' Do Initials White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant State of Florida, Department of Health, Bureau of Vital Statistics -- — BURIAL TRANSIT PERMIT HEALTH DATE PRINTED: April 26. 2024 TRACKING NUMBER: 2024075114 1. DECEDENT INFORMATION Name of Deceased Date of Death WILLIAM EDWARD KEESEE ApH122. 2024 Place of Death - County City, Town or Location Name of facility, or street address if not a facility ORANGE ORLANDO EXCELLENCE SENIOR LIVING Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. NoJReg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN. FLORIDA, 32958 Funeral Director/Direct Disposer Fla. Lic. NoJReg. No. KRISTOPHER MCDANIEL F418832 Medical Verification Statement ADVENT HOSPICE at the certifying physician's office, was contacted on 04122/2024 by the funeral director listed above; helshe indicated that STEVEN CRAIG GOLDSTEIN, certifying physician, will complete and sign the medical certification of cause of death within 72 hours. 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Penult Number 2024-1`041670-51)88 Date Issued: Apnl 22. 2024 State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District 9 Approval Number: 24-03619 4. CEMETERY OR CREMATORY Place of Disposition: VERO BEACH CREMATORY Method of Disposition: CREMATION Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. OH 326E, 10112 64V-1.011, Florida Administrative Code Name CX ,�c o le /� vl• /� 5�',E /G IQ1�N1141 A/5 J �Sl p . /i iciC� Unit Block Z Lot ' _r • Date of Mark -out /0 // s / / � • Date of Burial /0 A2 y /I Time Name of Funeral Home 572rvrr'A!- Authorized byl�lJ] U GLORIA G. KEESEE Mrs. Gloria G. Keesee, 85, passed away on October 14, 2015 at VNA Hospice House in Vero Beach. She was born July 31, 1930 in Barquisimeto, Venezuela and lived in Sebastian since 2004 coming from Ashville, NC. Gloria attended Virginia Intermont College in Bristol, VA, where she met her husband William E. Keesee. She was also a graduate of the University of Texas where she received her Bachelor's Degree in Architecture. Gloria's passion in life was her family, traveling, birding and hiking. Survivors include her husband of 62 years, William Edward Keesee of Sebastian, sons William Edward Keesee, Jr. and wife Sunny, of the Dominican Republic and Manuel Andrew Keesee and wife Grecia of Orlando, daughter Sandra Keesee of Sebastian, sister Adela Gil of Barquisimeto, Venezuela, six grandchildren and one great-granddaughter. MY OF 70 —M%Ni�i HOME OF PELICAN ISLAND Certificate No. 2438 CITY OF SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: William E. Keesee 1102 Breezy Way Sebastian,. FL 32958 In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Block 2, Lot 5 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 15` day of October, 2014. CITY OF SEBASTIAN, FLORIDA Joseph F. GriffiK City Manager ATTEST: Sally A. aio, MMC City Clerk 10/14/2015 13:25 44668 P.001/001 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MWICIPAL CEMETERY For information contact: Kip Kelso .Cemefery SexaDn Sebastian Municipal Ceme-ery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Stre et Sebastian, FL 32958 Office (772) 388.8215 or 38W214 Fax: (772) 589-5570 FUNERAL HOME: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue. Sebastian. Florida, 32958 PHONE#: 772-589-JWn (Check One) XXX OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE Lf�Gf,: uoj Lot_5_Block 2 Unit_�6LtLA-' v3I wn Lot —Block Unit Niche mock Unit N S E W BURIAL DATE AND SERVICE TIME: 11:00 AM, Saturday, October 24, 2015 — Chapel Service FOR DECEASED. Gloria Gil Kee5ee Name NAME AND SI ATUR OF LOT OWNER OR REPRESFNTATIw: (Must pro ' e rop cementation of ownership) �'`'`" i,�illiccrn I�.eeSte. >'Q�)�-Ir5 Name Signature Date I certify that I have determined the ownership of the above describe' 1 site that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: Tim Marvin Name )P114116 Ignature Date Cemetery Sexton Certification; I certify that I have checked the ownership information by viewing tUv owner's deed and confirming with Clerk's office //and that all fees have been paid: Cemeteryt on Date This form to be provided to Clerk's Office by Sexton for permanent *cord upon completion. CITY OF SEBASTIAN FINANCE DEPARTMENT RECEIPT ' 949 Name Strunk/ Reesee nCash Date 10-16-15 9Check # 7319 ❑ Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit- 001501 362100 Taxable Rent- 001501 362150 Non -Taxable Rent- 450010 369900 Airport Badge 001501 329500 Alarm Permits 001001 218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 369900 Miscellaneous Revenue 001501 359000 Other Fines/Forfeitures 001501 351140 Parking Citation 001501 342100 Police Security Services OD1501 343805 OMP&Tv FFRes o/r 250 00 I Total Paid 250•00 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant CITY OF SEBASTIAN CITY CLEWS OFFICE RECEIPT 4933 Name 1,L) 1 I I iam Keese- e, D Cash Date /0—/— ILI Acbeck # No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 CopkWB!d Specs. 001501341910 LDC/Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots /000.,90 Lot/Niche Block Unit 4 001501343805 Cemetery Fees tip Total Pald 1060.66 Initials White - Dept. of Origin 9 Yellow - Finance * Pink - Applicant r City of Sebastian Schashan Cemetery Ph. n 11772) 589 • 254.1; Fat N 1(7721 "N 9927 Nulr Ybi% Is for Infurmalional purpo.r% rrguardtng Alunumenl. At Sthaslian Ctrtlrirrs %oie ' I his h fur Single %larl.ers under 2 ft. & ostr 2 (1.1 o%rr 2 It. is a Nuurrd foundatiuu ) 1'leA.4. relutll lu Atltolwn 3—OxO-10xl-4 size name 6 date unit: blk )of square foot checked by: approved: date : by: City Of seha.lun SebAstian Cenitirr% 1921 North A%t:. 32958 Crender) Swouo upright grey slant IFuundaimn fusurt-d br:john/strunk no base date 12/23/14 %irmt ln.lallcd h%:john/strunk d'i" � 12/23/14 Ili.. : William KeeSee 11(•r : Gloria KeeSee D.O.B. 1928 ID.O.B. 1930 D.O.D. I D.O.1). 4 E 5 K.G.K. K.G.K. 12/23/14 John / strunk ( 1•icturr AK) %lurtunleut in ilucstian ) 36 10 16 " 12/17/2014 12:23 #3843 P.002/004 14UC 24 2011 10133AM HP LMSeRJET FAX P City t7f Sellastilin SVh#Xli4i, Cr.lkarcl. Pr. r It r7t 1 Gy-, 150 1'1% It 10111 11, - uvy? Wit : Thk+tf fnr lRrufni>zllPnal purpaty% rcRaar,lilcd hlufluvwgill 11 Srlja%til,l(j l'crrj,•icr% \u1p: Th4Isfur Slf+Xlt1t.rker.tiorldfr2R..\a►'fr2!1.(,nrr)lti.itaronwre,Jho �ii,]4IinAl rWhe return to City of SaDaivall Dry Mix 4e69,111an 0-rota• . / i9Z1 North i volrel hrs. )L Voutid 101111 frilur it I� 129 $A d ll�T by Altenrlaa ski N ('rAlrlcrr y�rtgrl r ' 1� dirk sU X Nsr71a d 01t(Q : HIS: IAJ i f I I q2.6 �e+pat pesarlpltivn � -�� ( Squsrt FL. dppnavad By Chi cxoofBy Ay . Erampla STRUNK FUNERAL HOME & CREMATORY 1623 No. Central Ave. SEBASTIAN, FL 32958 (77-2) 589-1000 o� City of Sebastian Sebastian Cemetery Ph. # 1(772) 589 - 2545 Fax # 1(772) 228 - 9927 !vote : This is for informational purposes reguarding Monuments at Sebastian Cemetery. Note : Please return to Attention Size Al vIg Names & Dates : His: D.O.B. D.O.D. Legal Description Unit Blk.: Lot: Approved By: Checked By: Date : By: Example it .. deep Sebastian Cemetery 1921 North Central Ave. 32958 Cemetery Sexton standa�P, granite flat grass marker K.G.K. K.G.K. everlasting stone works Her: D.O.B. Dry Mix Foundation noured by : everlasting /jamie date : stone installed by = everlasting / jamie date