Turner, Joseph KCemetery Call Work Sheet
/1t' /.Date:
F n1
Funeral Home / Monument Company: v��c�x�l,� �.
Contact Name: T\nr� - �C Iye,Tel. #: 7>1 sd F 0 Fax #: ANO (0- 5
Email: J ��-Y r L 1 moo)-+
Reason for call:
** Staking Request - Interment
$30.00 staking fee (Weekdays) - $50.00 staking fee (Saturday, Sunday & Legal Holiday)
Full Burial V Urn Burial
(One full burial and one urn, or two urns per space)
Owner of Plot:
Deceased Name: 'JO ✓�--e -&
Block ` Lot Spaces
Date of Birth: J /as/ 1.9 �aDate of Burial: 3 / 1 16/
**
•
Date of Death / ( /
Time: - am/pm
_ Monument (Marker) being placed - (No fee for staking of monument)
For:
Block Lot Space Date: / / Time:
Affidavit (Burial Rights) Verifying Burial space
Other reason:
Send email to P&R to stake the space -S s * 3f �ht?-
Notify funeral home/monument company with color of the flags
used to mark the space -B[0 -e_
Staking fee received on: 3 /0( From: \' Cr
Copy of permit emailed to:/71 /
Nathan Brigman, cc: n, Tim Chaplinsky, Erick Peterson in P&R on:
**************************************************************************************************
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
ORLS/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20
Revised 4/21/2021
CLEARWATER CARETAKER
CLEARWATER, FL
Permission is hereby granted for burial of:
Name of Deceased: JOSEPH K TURNER
Owner of Property: TURNER
Block: 4 Lot: 1
BURIAL PERMIT 3/21/2022
PERMIT # 1499
March 21, 2022
Burial Type: FULL
Space: 41 Date of Birth: March 25, 1932
Date of Death: March 11, 2022 Date of Burial: March 18, 2022
Funeral Home Director: JIM RUDOLPH
Time:
Staking Fee: $30.00 Fee Paid: 3/21/2022 12:00:00 AM
Clearwater Cemetery
By -J v Le,--
Veterans Funeral Care
03/15/2022 City of Clearwater
Date Type Reference Original Amount Balance Due
03/15/2022 Bill Staking Fee#41 Turner 30.00 30.00
Check Amount
--oSE' A \ .�0 KNtAfJ2.
BANK AND CASH AC
029016
Payment
30.00
30.00
30.00
State of Florida, Department of Health, Bureau of Vital Statistics
BURIAL TRANSIT PERMIT
HEALTH DATE PRINTED: March 17, 2022 TRACKING NUMBER: 2022055069
1. DECEDENT INFORMATION
Name of Deceased Date of Death
JOSEPH KEMPTON TURNER JR March 11, 2022
Place of Death - County City, Town or Location Name of facility, or street address if not a facility
PINELLAS PINELLAS PARK SUNCOAST HOSPICE CARE CENTER MID PINELLAS
Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No./Reg. No. Phone Number
VETERANS FUNERAL CARE INC F040002 F040002 (727) 524-9202
830 N BELCHER ROAD
CLEARWATER, FLORIDA, 33765
Funeral Director/Direct Disposer Fla. Lic. NoJReg. No.
LISA LUSTIG F045537
Medical Verification Statement
Laura at the certifying physician's office, was contacted on 0311412022 by the funeral director listed above; helshe indicated that
MARY CATHERINE WAECHTER, certifying physician, will complete and sign the medical certification of cause of death within 72
hours.
2. BURIAL - TRANSIT PERMIT
The Florida Department of Health, Bureau of Vital Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes.
Permit Number: 2022-F040002-5157
, r� 11 ---- Date Issued: March 12, 2022
State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: CLEARWATER CEMETERY
Method of Disposition: BURIAL Date of Disposition:
EDRS maintains all statutorily required information regarding the death record and related
burial transit permit, therefore, returning the permit to the county health department is no
longer required.
If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so.
DH 326E, 10/12
64V-1 011, Florida Administrative Code