Dillard, AlbertCemetery Call Work Sheet
ate: L/I
Contact Name: COY e re0,443t.."
Funeral Home / Monument Company: _
Contact # or Email: --7?-1 —10°)
Reason for call:
Viz
A: ** STAKING REQUEST for Interment
$30.00 staking fee (Weekdays) - $50.00 staking fee (Saturday, Sunday & Legal Holiday)
Full Burial Urn Burial
(One full burial and one urn, or two urns per space) 1)1.
Owner of Plot: e G
D‘ kA 0.1.0
Deceased Name:
Verify Ownership/Burial Rights in cemetery program before confirming:
Block Lot Space
Date of Birth: / / Date of Death / /
Date of Burial: / /
B: ** STAKING REQUEST for Monument to be placed _
No fee for staking of monument
Deceased Name:
Block Lot Space
Verify Ownership/Burial Rights in cemetery program before confirming:
C: ** OTHER REASON:
P/C3t (to
C' -,a. Q<J0 x-15
*****************************************************************************************************************************
Sent email to P&R to flag the space / /
Notified funeral home/monument company with color of the flags used to mark the space
Staking fee received (if applicable): / / From:
Copy of burial permit emailed to:
Nathan Brigman, cc: Matt Anderson, Tim Chaplinsky 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
ill3.) Written authorization from the individual(s) who would be permitted to authorize burial
City Clerk/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20
Revised 12/27/2023
Vaughan, Karen
•m: Vaughan, Karen
Sent: Friday, June 14, 2024 1:41 PM
To: gfeaster1@verizon.net
Subject: Dillard
Attachments: Dillard, Albert - Block 6 Lot 20.pdf
George,
Here are 2 pages of notes regarding the Dillard spaces at Clearwater Municipal Cemetery. Hope it helps!
Thanks!
Karen B. Vaughan
Administrative Assistant
City of Clearwater
City Clerk Department
Ph: 727-444-7150
Fax: 727-562-4086
•
•
1
Status of Block: 6 LOT: 20 as of 6/14/2024
• INTERMENTS
BURIAL DECL DECF DECM BIRTH DEATH INTERRED PERMIT
SP TYPE
1 FULL DILLARD MARY A 1/24/1834 9/18/1924 9/18/1924 0
2 FULL DILLARD S N 5/13/1862 4/25/1932 4/25/1932 0
ELIZABET
3 FULL DILLARD H N 3/25/1870 7/15/1939 7/15/1939 0
4 FULL DILLARD ALBERT N 12/7/1888 4/30/1965 5/3/1965 431
5 FULL DILLARD ELSIE H 1/9/1890 6/10/1952 6/10/1952 0
6 FULL WHATLEY ISABEL D 4/13/1917 5/7/1979 5/9/1979 1312
ELIZABET
7 URN BARRON H D 9/29/1913 2/8/1997 3/18/2020 1481
DISINTERMENTS
REINTERMENTS
•
•
6/14/24, 12:08 PM
Cemetery Tracking System
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Cemetery Tracking System - View Lot Profile
Block: 6 Lot: 20
Profile Summary
Click 'View Assigned' to view interment details. If more than one individual is interred in a space, a
second grid will appear below, displaying all of the individuals assigned to the space. Click 'View' on
the second grid to view the interment details of that individual.
EAST SIDE OF MYRTLE AVENUE
Space Owner Last Owner First
1 DILLARD OWNER:
2 DILLARD OWNER:
3 DILLARD OWNER:
4 DILLARD OWNER:
5 DILLARD OWNER:
6 DILLARD OWNER:
7 DILLARD OWNER:
8 DILLARD OWNER:
Owner Middle
Max Interred Total Assigned Interred
1 1 1 View Assigned
1 1 1 View Assigned
1 1 1 View Assigned
1 1 1 View Assigned
1 1 1 View Assigned
1 1 1 View Assigned
2 1 1 View Assigned
0 0 0 View Assigned
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