Yates, Jean (Ruby)• Cemetery Call Work Sheet
Date: / kc
Funeral Home/ Monument ComPan : Na'-hDncc? bk
Y
1
Contact Name:
Tel. #: Fax #:
20 i%k om
VVVVV
Reason for call:
V"lo--
Date of Birth: I l -7 l jQ 9 Date of Death / 3 / < /W C?
Block -ff- Lot I Space -4 -1 - lA vn I1J 1 ? ?•1 YYlYYb?
Owner of Plot: C'G' C .c . 7,jo
Interment: (One full burial and one urn, or two urns per space) -7
Full Burial Urn Space 7`
$30.00 Staking Fee - received on: / cs oy
/
Date of Burial:Time: amr
Disinterment:
L?]
1
Lot
+-11-4
Deceased Name: , ?C.h V-Ouf S -
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)
V /U b ?\q A)
ING)
Crystal Reports Viewer
Page 1 of 1
W # 1 / 1 Main Report I 100%
• Status of Block: 4 Lot: 11 as of 04/14/2009
INTERMENTS:
SPACE BURIALTYPE
i URN
1 FULL
2 URN
2 FULL
3 FULL
4 FULL
4 URN
5 INFANT
5 FULL
6 FULL
6 INFANT
7 FULL
7 URN
9 FULL
12 FULL
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
DECL DECF DECM BIRTH DEATH I
YATES C C 8/18/1890 06 / 09 / 1964 6,
PATTERSON JAMES W 3/22/1912 10 / 29 / 1944 11
ROWLEY PHILLIP W 10/1/1893 01/17/1959 1,
GRUMBLING MINNIE 4/21/1891 07 / 31 / 1983 8,
YATES CARLEY C 1/1/1890 01/01/1964 1.
YATES SYBIL MARTIN 2/3/1910 02 / 09 / 2000 2,
YATES RUBY J 1/1/1901 1,
YATES PAMELA J 1/1/1959 06 / 22 / 1962 6,
SLADE RALIEGH W 9/16/1874 1
SLADE JETTIE L 1/1/1880 01/01/1943 1.
YATES CHRISTOPHER S 1/1/1957 10/16/1957 1,
YATES JIMMY 4/14/1934 04 / 10 / 2006 4,
YATES JEAN
VOLLRATH CHARLES 1/1/1870 01/01/1932 11
HUNTER WILLIAM 2/14/1842 01/16/1933 1.
Page I of 1
J
1, 1H 1/1
4 4 r
http://msb-crystal-ent/businessobj ects/enterprise 11 /infoview/viewers/rpt/DHTMLV f ewer. a... 4/14/2009