Ward, John C & Mary ElizabethE
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Cemetery Call Work Sheet
Date: 5 /lb /_0 ?
Funeral Home/ Monument Company:
Contact Name: ? y LOLL ?L"--ZkF(-Lq
Tel. #:.&kf) =A ,$,$4q
Reason for call: U\ G L-? co C J g-IcA n b JA'a
N pl y ?? erv6ETh
Deceased Name:
Date of Birth:
Date of Death
Block Lot Space
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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