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Thornton, Max CP Cemetery Call Work Sheet 's 9,fO • Date: Funeral Home/ Monument Company: I rr©SS eCt ` &A Contact Name: Tel. #: X14- ?uw Fax #: Reason for call: 2 0 o e c Deceased Name: Date of Birth: /Y-' q o Date of Death d 0 Block Lot 114, - Space A- Owner of Plot: d oxwe5 Interment: (One full burial and one urn, or two urns per space) Full Burial Urn Space 1.10 $30.00 Staking Fee - received on: 0/ ,5/ vl? ?AO-) W f Date of Burial: 7 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) ?2-? cd ?eh,u ? ee ? ja?a f)lc(-t-f J-aAc, S,Lrv.,rtian?pg- A f¢eady ?? euve6 Staac.?.tiaj 6. • I , JUN 10' 2008 OF -,IECO D' l b LEG, , 5?-V June 10, 2008 ORLS P. O. Box 4748 Clearwater, FL 33758 Attention: Nicole Sprague I have enclosed my check in the amount of $30.00 for • the staking of Space 2 S 1 /2 Blk. 1 Lot 14 in the name of Max C. Thornton. The service will be later on this summer and Moss Feaster Funeral Home will notify you of the date. Thank you for all courtesies. Sincerely, Jean B. Thornton 850-984-5837 0 ACM I I i as L L x LL U d l1 ? I I 1I In 0 f x ® J - N c 0 x F U d li .7 I_ __?1 -If Of L2 9?S CZ ZZ.. ? W V/ z f[ ? ?..•.£ 2C ez •z- V 1 sz Yz Iz 01 a, II OZ Y I[ G Of 8 2 ? f ? 21 61 ? SI •1 61 ZI I 01 2. ? 6 C B II b L bl C-C VVV \ 7 .06 -S J- 9 51 91 1 6 91 LI tl ?1 C2 - t. 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' I Ls ? 9c u - CEMETERY BURIAL INFORMATION BY BLOCK/LOT/SPACE • BLOCK : 1 LOT: 14 DECEASED NAME: JEAN B THORNTON BLOCK: 1 LOT: 14 SPACE: 1 BURIALTYPE: FULL BORN: 01 / 01 / 1901 DIED: INTERRED: INTERMENT NOTES: RIGHTS IN DEED FILE DECEASED NAME: MAX C THORNTON BLOCK: 1 LOT: 14 SPACE: 2 BURIALTYPE: FULL BORN: 01 / 01 / 1901 DIED: INTERRED: INTERMENT NOTES: RIGHTS IN DEED FILE DECEASED NAME: DARYL D THORNTON BLOCK: 1 LOT: 14 SPACE: 3 BURIALTYPE: FULL BORN: 01 / 01 / 1901 DIED: INTERRED: INTERMENT NOTES: RIGHTS FOR DARYL IN DEED FILE DECEASED NAME: GRANT B THORNTON BLOCK: 1 LOT: 14 SPACE: 4 BURIALTYPE: FULL BORN: DIED: INTERRED: INTERMENT NOTES: AFFIDAVIT GRANTING RIGHTS IN DEED FILE DECEASED NAME: RICHARD A COLEMAN BLOCK: 1 LOT: 14 SPACE: 6 BURIALTYPE: FULL • BORN: 04 / 03 / 1855 DIED: 02 / 16 / 1907 INTERRED: 02 / 16 / 1907 INTERMENT NOTES: DECEASED NAME: SUSANNE BLOUNT BLOCK: 1 LOT: 14 SPACE: 9 BURIALTYPE: FULL BORN: 01 / 01 / 1901 DIED: 10 / 01 / 1895 INTERRED: 10 / 01 / 1895 INTERMENT NOTES: DECEASED NAME: JAMES R BLOUNT BLOCK: 1 LOT: 14 SPACE: 10 BURIALTYPE: FULL BORN: 01 / 01 / 1901 DIED: INTERRED: INTERMENT NOTES: DECEASED NAME: MAX C THORNTON, JR. BLOCK: 1 LOT: 14 SPACE: 12 BURIALTYPE: FULL BORN: DIED: INTERRED: INTERMENT NOTES: AFFIDAVIT GRANTING RIGHTS IN DEED FILE DECEASED NAME: UNKNOWN BLOCK: 1 LOT: 14 SPACE: 13 BURIALTYPE: FULL BORN: 01 / 01 / 1901 DIED: 01 / 01 / 1901 INTERRED: 01 / 01 / 1901 INTERMENT NOTES: OCCUPANT UNKNOWN • ****END OF BLOCK : 1 LOT: 14 **** Page 36 of 43