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Home My WebLink About4-02-40Unit Block Lot Date of Mark -out Date of Burial /� j Time =� Name of Funeral Home Authorized by GERALDINE STAPLES Geraldine (Geri) D'Acunto Staples passed away at the age of 66 on July 17, at the Sebastian Medical Center. A 17 year resident of Sebastian, Geri was born March 22, 1948 in Stamford, Connecticut. She graduated with a cosmetology certificate from J.M. Wright Technical School in Stamford and opened her own salon, Geri's Coiffures, at the age of 20. She successfully operated that business for 27 years until retiring to Florida. A loving presence to all who knew her, Geri was third in a family of 7 brothers and sisters. She was the keeper of all things family, and could be depended on to keep everyone abreast of the myriad goings on of a far flung group of siblings and their families. To her three cherished grandchildren she was grandma, and the greatest pleasure of her last years were the many hours she spent caring for and enjoying them. Geri is survived by her husband of 42 years, William Staples. She leaves behind her daughters Paige Newinski and Robyn Krajewski, son in law Todd Krajewski, grandsons Quintin Newinski, Ian Krajewski and granddaughter Emily Krajewski, all of Sebastian Florida. She is survived by brothers: Richard Carlo of Deep River, Connecticut; Joseph D'Acunto of Barefoot Bay, Florida; Phillip D'Acunto of Manchester, New Hampshire and sisters Patricia Hair of Port Charlotte, Florida; Jessica Bray of Lake Wales, Florida; and Betsy D'Acunto of Sioux Falls, South Da kota. Name Unit Block Lot Date of Mark -out ( 1 ' , ' / Date of Burial / /TJ ✓ (' Time Name of Funeral Home w I<- Authorized by FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY Far- jig*0 + , .r 0 For information contact: Kip Kelso .Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 9225 Main Street Sebastian, FL 32958 Office (772) 388 -8295 or 388 -8294 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE #: 772 -589 -1000 (Check One) X OPEN BURIAL LOT Lot 40 Block 2 Unit 4 OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: Monday, July 21, 2014, 10 :00 AM - CHAPEL FOR DECEASED: Geraldine Emily Staples Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) William Prescott Staples Lk_)vL&-Y � " , 7/18/2014 Name Signature Date 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 DIR CTOR: Tim Marvin 7/18/2014 Name Signature 5 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: a a A 1 Ceme ery S xton Date" This form to be provided to Clerk's Office by Sexton for permanent record upon completion. FUNERAL DIRECTOR' REQUEST TO CITY OF 5E�ASTtA RY OPENiN(3 IN SEBASTIAN MUNICIPAL CEM�T FOR URIAL 5 ' noµt a itlCru+KU►� .. For Information contact: Kip Kelso • Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's office City Hall, 1225 Main Street Sebastian, FL 32958 office (772) 389-9215 15 r 08.8214 -- - Fax. ( ) FUNERAL HOME, ADDRESS: PHONE #: (Check One) Lot Block ,�„ .... ........S3PEN BURIAL LOT Block-Un+t ..... PEN CREMAII�IS t.0't' _Lot .Unit . PEN COLUM�ARIUM NICHE Niche,,BlockW BURIAL DATE AND SERVICE TIME: FOR DECEASED: va NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE. (Must provide proper documentation of ownership) 50nA j,� 3 lv iJ6 acne tgnature Date I Certify that I have deormined the ownership of the above described Bite that all site fees and administrative fees hake been paid and authorize opening of same NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR. 1.4Date am Ne "".r..._ ' ignatUre--------••-•--•---•-.......... ------------•----•----•-•-------•--•---•----------•---- ---••---- ... ............... ••.---..r--..r Cemetery Sexton Certification: I certify that 1 have checked the ownership information by viewing the owner's deed andconfirming with Clerk's office :and' that 8ll fees have been paid Date L16 ernetery 7extont This form lobe p rovidied to Clerk's Office by Sexton for permanent record upon completion. CITY OF SEBASTIAN 10072 ADMINISTRATIVE SERVICES RECEIPT Name Mr, I �b �2S ❑CCash Date �prkl ��-•2S�iGAheck# 313 Q Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit 001501 362100 Taxable Rent 001501 362150 Non -Taxable Rent 450010 369900 Airport Badge 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 329200 Site Plan Review 001501 329300 Subdivision/Plat Review 001501 329100 Zoning Fees t,)01501 39 ,� 8105 0& U 4 a 2 L14 0 Total Paid Ini als Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow -Admin. Svcs. • Pink - Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE 4895 RECEIPT Name William Staples 7 -18 -14 No. 001001 208001 001501 322900 001501 341920 001501 341910 001501 341930 601010 343800 001501 343805 ❑ Cash kheck# 4003 Amount Paid Sales Tax Garage Safes Copies/Bid Specs. LDCICode of Ordinances Election Qualifying Fees Cemetery Lots 1,000.00 LoVNiche 40 Block 2 Unit 4 Cemetery Fees Total Paid 1,000.00 Initials White — Dept. of Origin • Yellow — Finance • Pink • Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE 4897 RECEIPT Name Strunk /Staples 7 -18 -14 No. 001001208001 001501 322900 001501 341920 001501341910 001501341930 001010 343800 001501343805 ❑ Cash K Check# 7060 Amount Paid Sales Tax Garage Sales Copies/Bid Specs. LDC /Code of Ordinances Election Qualifying Fees Cemetery Lots LoYNiche . Block Unit Cemetery Fees 0/c 150,00 150.00 Total Paid Initials White — Dept. of Origin • YeIIaW — Finance • Pink - Applicant 12/11/2014 11:40 3212598690 PAGE 01 • C` r ( 11.3' v/ +S'ebrr.sifan I't)!iT oil I(:1 If()X 7iff17.7 !ii IIA!tIIAN• rI()fiR)A ; 9)f1 r. nu, (C(1/) 509 5IMI +' TAx Mni) !f ) Van NOTE: THIS 1" FOR INFORMATIONAL !'UTTI'ti ter:; HEMODTMG t•tnNUMT:N7'S AT SEBASTIAN CEMETERY: PLEASE BETORN Test c tTy or SEBASTIAN SEBASTIAN CITY BALL 1225 MAIN *STREET SEBASTIAN, r).. :T7.'1 in • SIZE: 2 �` �d�/ / s.�" ' 1 ` ' (i�U 64% 2-0 / °'/D X 1--f 1, HIS NAME: D.O.B. : D.O.D. • HER NAME: GERALD/ NE- D.o.B. : P1412_cg , L0'1 S D.o.D.._a- y_ /7) Z [? 1 (14 PST: . LEGAL DESCRIPTION: POW/DA7<aI,� C "An. .43/1,. BLOCK: ! rp W7/ LOT: 17) 6 y ' i/ Al//n01-14irix_ / CN'�/ SQUARE FEET: _ 'D 44 rt.:. /Lji8/,7 APPROVED: CHECKED BY: DATE: BY: SUBMITTED BY: EAST COAST MONUMENT COMPANY 2( 724, ( 14 7 ( 1124 —7el 4- C q-L4 / F'A' Peet,-N9 / S• /Veer 00, 114.0r-,L �v , /`/ `�+,1Y //,r/, /'A'`^ ^" '"+""~'"^^/ 'p"~` '''.^"/ ...� `'� ' ° ^ ;.` ^.``.' , ^ � � /. . '.. `. ,.'^^,.."` '/'^`` ' "'''^ ^. o. °^^ , 'vmox "/ `~,=/,^" k °.w +'4', " u"... ...� r^`r � � C'.,"/~" ` � .O0 � ^ 24 " x10 " x16 " `m". »�v�� 8.C.Ol� u*, no*e& uao n, '-�--- - '` geraldineS�8D�s //'��x I) () I) -----� --- -- - |9*o ----- /'--� »*/ 4 ---- ---�--- ------��1� -�__ _ blA F�l --� - -- - � -- —|�|------- Jot ' --- 40 Sv"arefoot comchrx^y _�_--- _--,"( K -- - ----- ---�-- - -__ _ - ^pv/o,ox 1. n x - - -- - - _ ria m 12/11/14 -'-- -- -� -� -- ��.C.00. -- - - -- »:". � `' `/ .|. ..o"" i---- -� - - _ 10 ��-� ' - - '4 ' -� -� 1