Laster, Marie
Cemetery Call Work Sheet
Date:
Funeral Home: Monument Company:
Contact Name: hl4490,01-1 Contact Name:
Tel. #: (4'?> ? t 1
Fax #: 1+4'a) I a+(
RE:
Tel. #:
Fax #:
Deceased Name: M aA? LcL%1 . DOD: ?CgXr-> DOB:
Owner of Property:
Block Lot '!a Space
51-7 0Z)
Interment Full Burial: Urn Space:
($30.00 Staking Fee) - (One full burial and one urn, or two urns)
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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