Trott, Matilda (Brancy)
Cemetery Call Work Sheet
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Date: 11 / aa- / a.0l o
Funeral Home/ Monument Company: Moss Feaci.CA.
Contact Name:
Tel. #:
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Reason for call:
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Fax #: 5 t, 1- a o 4Y3
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Deceased Name: (?rA&%?yl
Date of Birth: S l a l 11 IS' Date of Death II l 1Y.1 a.o!'o
Block 7 Lot tarl Space -?- A f ?i .Qav .?' y4di,) n d""'`'
tsti, Q? ? r'lwt Q ?a?3rR ?
Tro'1''f°
Owner of Plot. (i e-
****** *********************** ******************************************* *********************** Tro- t-
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space 4t
$30.00 Staking eFee -received on: a-°t? c&n-f' ??d-?
W
Date of Burial: Time: am/pm
Disinterment:
The following authorization should be obtained prior to disinterment:
1.) A disinterment permit and burial/cremation transit permit
2.) Written authorization from the individual(s) who currently own the burial rights
for the plot; and
3.) Written authorization from the individual(s) who would be permitted to authorize burial
Monument Being Placed: (No Fee for Staking of Monument)
0
Cry,stal Reports Viewer Page 1 of 1
9,3 N 1 / 1 Main Report 100%
Status of Block: 7 Lot: 139 as of 11/22/2010
INTERMENTS:
SPACE BURIALTYPE
1 URN
2 FULL
3 FULL
4 FULL
DECL
WORDEN
TROTT
TROTT
TROTT (BRANCY)
DECF DECM BIRTH DEATH INTERRED
ELOISE T 6/16/1917 03 / 24 / 1995 4/6/1995
JOHN H 1/1/1878 01/01/1940 1/1/1940
SALLIE D 1/1/1881 07 / 21 / 1970 7/21/1970
MATILDA
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
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http://msb-crystal-ent/businessobjects/enterprise 11 /infoview/viewers/rpt/DHTMLV iewer.aspx?skin=ski... 11/22/2010
LaCosse, Judith
From: Taylor, Joe
Sent: Tuesday, November 23, 2010 11:00 AM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie
Subject: RE: Cemetery Staking Request
I used Yellow flags.
From: LaCosse, Judith
Sent: Tuesday, November 23, 2010 8:07 AM
To: Taylor, Joe
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie
Subject: Cemetery Staking Request
Hi Joe,
We received a call yesterday from Susan at Moss Feaster in Dunedin requesting a staking for an Urn burial for:
Matilda (Brancy) Trott, who passed away on November 15, 2010. She's to be buried in Space 4 of Block 7. Lot 139.
Owner of plot - Sallie D Trott
Other burials nearbv in this Blk 7, Lot 139:
Space 1= Eloise T Worden - Urn
Space 2 = John H Trott - Full
Space 3 = Sallie D Trott - Full
Space 4 = for Matilda (Brancy) Trott - Urn
Date of Burial: Wednesday, December V, early afternoon.
Please advise as soon as you can the color of the flags used to stake this area. We will then, notify Susan at Moss
Feaster.
Thanks for your help.
Judith LaCosse
Staff Asst.
Official Records t& Legislative Services
727-562-4093
November 23, 2010
Attn: Susan
Funeral Home: Moss Feaster-Dunedin
Fax: 727-562-2043
(This fax includes a copy of Cemetery Map)
# in the circle is the Block, # in the square is the Lot
Deceased: Matilda Brancy Trott
Gravesite: Block 7, Lot 139, Space 4
Urn Space
Gravesite flagged with Yellow flags.
Nearby Burials:
Space 1 = Eloise T Worden - Urn
Space 2 = John H Trott - Full
Space 3 = Sallie D Trott - Full
q I?
Staking Fee: 30.00 R alao ?o ??? ?? ( q
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept. - 2nd Floor
112 S. Osceola Ave.
Clearwater, FL 33756
Please contact me with any questions.
Thank you,
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
Vendor No. Vendor
3141616 CITY OF CLEARWATER
11/30/2010
10097971
PAYMENT DETAILS
Staking Fee - Clearwater City Cemetery
Brancy Matilda Trott
Moss Feaster Funeral Home and Crema Amegy Bank N.A. ss 552s 10097971
1320 Main Street Porter, TX
Dunedin, FL 34698 1530
' 11/30/2010
PAY Thirty and 00/100 Dollars
q,.
PAY TO THE
ORDER OF
***********$30.00
zW,4111,11il
Mernu: Brancy M Trott
l1' L009797 Lli' 1: L L3 L L05aD: 44440 70 7 2ll'
BURIAL PERMIT
CLEARWATER CARETAKER
CLEARWATER, FL
Permission is hereby granted for burial of:
Name of Deceased: MATILDA TROTT
(BRANCY)
Owner of Property: SALLIE D TROTT &
Block : 7 Lot: 139 Space: 4
Date of Death: November 15, 2010
Funeral Home Director: SUSAN - MOSS FEASTER
Time: 12 :00 Staking Fee: 30.00
PERMIT # 2619
December 03, 2010
Burial Type: URN
Date of Birth: May 12, 1915
Date of Burial: December 1, 2010
Date Paid: December 2, 2010
Clearwater Cemetery
By uIX.;.? ?K-?_