Moessing, Herbert G
Cemetery Call Work Sheet
Date: 3 / / aboq
Funeral Home/ Monument Company: H,, ?L jP
Contact Name: tA-( 4 Mead ow s / Ke",
Tel. #: 58q-?G-7I
Reason for call: I??t w?t4t, -A
Fax #: S 8Y- 10-7J
bc,r-' &. hVeSSit- .
Deceased Name: H QA LXJ C- M a S s."
Date of Birth: (- / I'f / 19 °? Date of Death
Block 1,5 Lot Space 1 5
h
Owner of Plot: er?t l (? oe s S l
**************************************************************************************************
Interment: (One full burial and one urn, or two urns per space)
Full Burial ? Urn Space
$30.00 Staking Fee - received on: K o • a 5y
lo: o?
Date of Burial: 3 / 9 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)
ATTN: Ken (c- Hubbell Funeral Home
Fax: 727-584-1073
Deceased: Herbert G. Moessing
Gravesite: Block 15 / Lot 79 / Space 1
Full Space
Full Burial to take place Monday, March 9th after 10:00 a.m.
Surrounding gravesites:
(wife of deceased, Sarah Moessing in space 2)
Staking Fee: $30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept.
112 S. Osceola Avenue
Clearwater, FL 33756
Please contact me with any questions.
Thank you,
Judith LaCosse
Staff Assistant
Official Records & Legislative Services
727-562-4093
CEMETERY BURIAL INFORMATION BY BLOCK/LOT/SPACE
BLOCK : 15 LOT: 79
DECEASED NAME: SARAH MOESSING
BLOCK: 15 LOT: 79 SPACE: 2 BURIALTYPE: FULL
BORN: 12 / 07 / 1908 DIED: 02 / 18 / 1993 INTERRED: 02 / 22 / 1993
INTERMENT NOTES:
service scheduled for sometime in am
DECEASED NAME: ELSIE BROOKS
BLOCK: 15 LOT: 79 SPACE: 3 BURIALTYPE: FULL
BORN: 05 / 19 / 1905 DIED: 01 / 25 / 1991 INTERRED: 01 / 29 / 1991
INTERMENT NOTES:
DECEASED NAME: JOHN RADCLIFFE
BLOCK: 15 LOT: 79 SPACE: 4 BURIALTYPE: FULL
BORN: 12 / 09 / 1895 DIED: 02 / 05 / 1979 INTERRED: 02 / 07 / 1979
INTERMENT NOTES:
****END OF BLOCK : 15 LOT: 79 ****
Page 79 of 120
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