Sawyers, Betty B
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Cemetery Call Work Sheet
Date: 8 /.--A / ap
Contact Name: M?
Tel. #68 13 Fax #
Funeral Home/ Monument Company: ?11"Ic ,
-7 9,1 94 1,)-
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Reason for call: emu --P
Deceased Name: I yg+ c-e C-Q-CZ
Date of Birth: Date of Death / /
• Block Lot Space
Owner of Plot:
**************************************************************************************************
Interment: (One full burial and one ur o urns perspace)
Full Burial / Urn Space
$30.00 Staking -fee -received on:
OaTe 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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