HomeMy WebLinkAbout1-08-32JUL -18 -2012 WED 11:15 AID
From:The UPS Store 4239
MCB Bristol Highvay
7725899175
FAX No, 423 232 5134
0711712012 10:56
P. 003/005
#500 P.0021007
C�
00
)40ME of PEUCAN MAND
Burial rights in the Sebas ian Municipal Cemetery lots /niches purchased by me
(Please print name and address oT purchaser)
(Lot/niche, block, unit description)
are intended for interment of the following Individuals:
T
I b
Please print name(s): ll
fal-
(2) C�t —, t r�t��1FY� (7 (12)
(3)L�nC'� �%(C�K•Z.r'S {a) �Prrc �� c�4r5 {jail VrvK� S
l4) l�,1�zyS (g) (14) ViLILerS gLDl -
r�1C+ (10)C%1 pC*-ems} (1SLV.''a
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,
t ;nature re d u to I e arms Of this agreement.
5 Date
yr' dny er AW �--- ZO tiZ by
Subscribed and swo m before mwho INS personalty known �me, o► has Oroduoed
q4 rl�C2'7t.3 asldentirloollon.
T STATE L
Nolary Public. Slate o4*brPdm , r^
a : OF
Hamas of 1ntsm)0 form TENNESSEE i �7
tr :• NOTARY 1 ft `
PUBLIC
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JUL -15 -2012 WED 11:15 AM
From:7he UPS Store 4239
MCB Bristol Higirlway
7725899175
FAX No. 423 232 5134
07117/2012 10:56
P. 004/005
#500 P.0031007
ona
N
NOME OF PEUUN IMND
ri hts to the ',S��bastian Municipat Cemetery tats /niches purchased by me
�G U� -(ruYer )Q„C --so- TIJ 3 '7
(Please print name and alldress of purchaser)
, unit
are intended for interment of the following Individuals:
Please print name(s):
U�3(�i Il;c;zrz:� rat 1- t �J,�� %t, 4��,� .�rr� 01 C>
O c Y, CY,1Q -r , j c'�- (�a'} J• y r3 ra LF,: �6c+ L j t ��i�) V rc Jl`� r s 10�
tom'' f�I�(�a— Uaj�ilh� �ic ke
►���
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 an to heirs but the City requires a certifiers copy of relevant probate or other
court documents.
I h d ut he terms of this agreement.
5igneture Date
ubsCri6ed end �� before
UIM
Nvlery Public. ute ollerida
Namac of IrAwrvd form
the 4111 day of
who kmrwn
ldenliRp�
° ,L ;
y'•: c°e RIFF C:
rriri�l���,`
W k�- by
ttte' or tInN produced
C V;Ca.Z.e. -s Up
JUL-18 -2012 WED 11:15 AM
From:The UPS Store 4239
MCB Bristol Highway
7725899175
ona
40ME of pWCAN ULAN
FAX No, 423 232 5134
07117/2012 10:57
Burial rights in the S bastian Municipal Cemetery lots/niches purchased by me
Ei its s L� �'` 1 � TP
(Please print name and address of purchaser)
--
fl-at/niche. block, unit description)
are intended for interment of the following individuals:
Please print narne(s):
(11 )
(1-- 4- ( 7/ ,,J-) r� vsn ,� . "z (12 )
v3 v i c K ems o
F. UUVUU�
#500 P.004 1007
5 n ib�- _(
:sj✓jo j14- (15 )
09
Interment lots /niches are not to be transferred without written approval of the City of
Sebastian. Interment lotslniches 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 rst �the of this agreement.
Signature Date by
S bs sibed and to bergs me Ibis ,n -a—
ay ` Onl�4z i has pro �d
who le personalty k P
.............
•..�i•
Ok
Notary Public. Slate of Florida T',J = `� ; 4,, C
Names oflMem)dform
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