Hagel, William Flores
• Cemetery Call Work Sheet n J
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Date:5 /15D/ 09 jq
Funeral Home/ Monument Company: 0
Contact Name: Joe, ftwLb ro
III
Tel. #: 191 ` 01-,- IV Fax #: 0&
Reason for call:
T,,. LU
Deceased Name: j01 j t la,?i ? "()46A
Date of Birth: Date of Death
/?/
• Block /?) Lot X Space I
Owner of Plot:
**************************************************************************************************
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
$30.00 Staking Fee - received on: -/-/.
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)
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