Benson, Lois%? f
•
Cemetery Call Work Sheet
Date: //Q I h
Funeral Home/ Monument Company: Nff5` 1'Z--- _
Contact Name: pau-p
Tel. #: DL-19? " ao I C Fax #:
Reason for call:
cst-
I Qj3d X. ht m 2") ,
Deceased Name: l5 MbMM- Unc-to
Date of Birth: (?i / / Date of Death 1 /?/ > 10
• Block ?_ Lot 5,S Space
Disinterment: -30. ,c,
The following authorization should be obtained prior to disinterment: ?' ??ytl 1°
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
Owner of Plot: VWP.
Interment: (One full burial and one urn, or two urns per space) ?.b b? a l
Full Burial Urn Space
$30.00 Staking Fee - received on: I / I / ao I o N"?
Date of Burial. Ti '
me. am/pm
3.) Written authorization from the individual(s) who would be permitted to authorize burial
Monument Being Placed: (No Fee for Staking of Monument) 0-1
U A\A ?
Qmetery Tracking System
CJ
Page 1 of 1
T?lYr11\FM F1
?;IV"['l?.lt?ET Good Afternoon! Today is Wednesday, 7anuary 20, 2010 Home I Feedback
Cemetery Cemetery Tracking System - View Lot Profile
File
Block: 15 Lot: 53
Transaction
f
l Profile Summary
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View Lot Pro
e
Click 'View Assigned' to view interment details. If more than one individual is interred in a space, a
S! Reports 'second grid will appear below, displaying all of the individuals assigned to the space. Click'View' on
the second grid to view the interment details of that individual.
Print Burial
Permit
WEST SIDE OF MYRTLE AVENUE
Search Names and E Space Owner Last Owner First Owner Middle Max Interred Total Assigned Interred
Notes
1
DEMETER
ILONA
1
1
1
View Assigned
Search Old 2 BENSON LOIS B 1 1 1 View_A...ssign..ed
Locations 3 BENSON LOIS B 0 0 - 0 View Assaried
g Print/View Lot 4 STUBBS NORMA 1 1 1 View Assigned
Status
1
Monthly Memo
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a
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Updated on Tuesday, January 06, 2009
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1/20/2010