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JUL-1k;2012 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
. 441111P
HOME OF PELICAN ISLAND
Burial rights In the Sebastian Municipal Cemetery lots/niches purchased by me
J _V` _
(Please print name and address of purchaser) -j' I-i '.4 1 b 0 I
(Lot/niche,
block, unit description)
are intended for interment of the following individuals:
Please print name(s):
(1) L (6) ;C-RerS foI 1 (11) Vic...*-0-5 p) -
r
• ('12) 1.1 ! ei- 4 V ci kP-S
(3)1F &n o-- V'!GK•e...r s (8) Senr0 ) C c 4Y5 (13) iikkAttl tit(: ti"5
(4) (9) (14) V,c •''3 e
(5) jit,K-tcs e15,A (10) a{. •1 Ent*-kr- (15)Y/c '-e rjo
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 h re d u to a errna of this agreement. Z
G% .1' /7 r
nature Date
Subscfibed and ew. t before roe this
1n day cr Zo lir by
l a Snn,Jv V who is personalty known io -me, or has produced
_ as l4eMifioiilon. `\````���ALE��IC��'�.
` 4J4\4_. ‘ 1,1110 . Z.Q .''STATEc G���
Nolary Public,sbteof lertda -ra a .. .•-.,
;cLj� OF =
Wows of Intoned ions = 2 1 TENNESSEE I z E
it). NOTARY l
Ti\-. PUBLIC
0;9 .4• ...........G
/
JUI-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
S�� ono a N
4 1 i a IN k)
. NOME OF FEUCAN ISLAND
Burl I rights in the',S�ebastian Municipal Cemetery lots/niches purchased by me
;GLtt U 4ie/5 (( 5" (j Jar ),3 c )11..01.) C./ 9 To 379/
(Please print name and address of purchaser)
LA" 5o 4-.71 floc. . a Ut f4- 1
(Lot/niche,block, unit description)
are intended for interment of the following individuals:
Please print name(s): ,�,/
U46 W� II i c.iL�. pIol (PI 61) a3re--t Li-toc; PI w') 16(... -z•5 plta4-
Verb -)) v -ers ek-t- f( 7- o. s;=n 6,3-1) V 1c.k..e,5 p)4--
1E I 1 c .r ,1 G'4-- ( - ) > c Le c+� per)Cam) Vi c1KwvS plu1--
,/)6.9) )cr, v('GKer s A 4) P I.5 t. x. or (>1 4)771 a Uwe{l4 S ra4k ,
( P J).F Q b c y r V 1 ` • s (76-(06) e'-'6.1\ '(I 6�r5 2 ) `nf`- 1 L • ;citi`Q' 5 Vs?
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 t a terms of this agreement,
Signature Date
ubscribed and sworn to before me lhtsdey of _t .___. ?1� by
rvho IQ,C�.A�rep�1�1 !���known me, ar Ana produced
is IdentilAt ,•r, ' � ?/,
L Nv ary Public,Slate of�Jarlda c /4-,,, 0A N� "'-
Names of Irtterte0 form y.A& Tfl" i
'///�..lf i r 1 I I I.`````.
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
l �
coo
SEBASTIAN
41011W
HOME OF PELICAN ISLAND
Burial rights In the bastion Municipal Cemetery lots/niches purchased by me
E E ,c 5 165" Tvciser 1/4PE 506)4,0 C[it k -rid
(Please print name and address of purchaser)
(Lot/niche,block, unit description)
are intended for interment of the following individuals:
Please print name(s):
(• 3 01 - v -- (11 )
w�.rc3—
( ,, 'C ' ,■ a 4— (7/ 1-1 Sf %�-- (12)
4 (v3) V f C.---erSnl01- (7t ) L.t°lu.)5zel )D-- (13)
( ) ( ?)q)VI GK•L.Y'"7 Sr pion— (yie, Lpt,i , ipio4' (14)
() t04- -s ( r ) (1) L .104 (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.
1 have d and nd t d the terms of this agreement.
-7 - / 7 - f 2---
Signature Date
in �
Bucn Gi q� to belos me this __-_____day Y t k [ -- by
who b personalty k K
i.pr has produced
\12 Val. L stL_c a'LLp S. as identification. s�,.....--......... ,,,A/,;
Notary Pubtlo.Slate of N:lerida 11.3 — *I H '1'F C
Names of Intoned hxm e4C1' e: '►f