Scearce, Anita L WilderCemetery Call Work Sheet
Date:.)urq 14,.E-a)4
Funeral Home: v0.50(\ FUneY0J ?W
Contact Name: L-Isa 'k lssfil9EY Contact Name: )-l ?-; ' •5 ? ?-) "VI,
Monument Company: qaL?, t , C
Tel. #: (72'7) q3q - 4,111
Fax #: 02q) 93N - 1060
Tel. #:
Fax #:
RE: 6YUr &Aj LAO
Deceased Name: ant, fA L. W1*(Sc ?C-P- DOD: f) aA 10 4 DOB: I ? I e -.I-
Owner of Property: Wiljiam J. 1r (WeY
Block 3 Lot r Space q
Interment: ? Full Burial: °?v Urn Space:
($30.00 Staking Fee) - (One full burial and one urn, or two urns)
Date of Burial:-.1U+-'? ? 51 ?`A 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)
S:/Jlacosse/Cemetery Call Work Sheet.doc 6/8/04
Alfaro, Rosemarie
From: Alfaro, Rosemarie
Sent: Thursday, June 24, 2004 11:57 AM
To: King, JoEllyn
Cc: Norman, Lois; LaCosse, Judith; Reehling, Dottie; Kaushal, Mona; Gracie, Rhonda
Subject: RE: Cemetery Issue
Importance: High
ci b-P k4- f
ICC.?. G?i ifS ?'lxt ?C% JC?1P :S(?l?ec_ _Ct?lL ?tld11Z-lt1 J?UCkC ?. G,
Jo Ellyn - t?ere as been change in space - please stake space # 6 (between William J Wilder and John H. Scearce).
Please call me with me any questions. Thank you.
-----Original Message-----
From: King, JoEllyn
Sent: Thursday, June 24, 2004 10:00 AM
To: Alfaro, Rosemarie
Cc: Norman, Lois; LaCosse, Judith; Reehling, Dottie; Kaushal, Mona; Gracie, Rhonda
Subject: RE: Cemetery Issue
We will get today. It will be yellow flags. Problems I will call you prior to end of our day which is 3:00 PM. Thanks Jo
Ellyn
-----Original Message-----
From: Alfaro, Rosemarie
Sent: Thursday, June 24, 2004 9:40 AM
To: King, JoEllyn
Cc: Norman, Lois; LaCosse, Judith; Reehling, Dottie; Kaushal, Mona
Subject: Cemetery Issue
Importance: High
JoEllyn:
Hello. The following space needs to be flagged. The interment will take place on Friday, June 25.
Name of the deceased: Anita L. Wilder Scearce
Please stake Space 9, Block 3, Lot F
Landmarks - To the North: Mary L. Wilder, Robert F. Wilder, John H. Scearce; two spaces West of John H.
Scearce: William J. Wilder; Directly to the South: Walter Vernon Sanders.
JoEllyn, please let me know if you are able to stake this space with such short notice.
Thank you.
Rosemarie
x4089
Tracking: Recipient Read
King, JoEllyn Read: 6/24/2004 1:02 PM
Norman, Lois Read: 6/24/2004 12:48 PM
LaCosse, Judith Read: 6/24/2004 11:58 AM
Reehling, Dottie Read: 6/24/2004 12:01 PM
Kaushal, Mona Read: 6/24/2004 11:58 AM
Gracie, Rhonda
L. City of Clearwater, Florida
0
>- Clearwater City Clerk Department
Phone (727) 562-4090
Fax (727) 562-4086
FAX MESSAGE
TO: Leslie Dougall-Sides
LOCATION:
FAX NO.: 562-4021
COMMENTS: Re: Interment of Anita Scearce
Attached is a faxed copy of the requested letter.
Please advise if you foresee any problems with the
letter.
We will proceed with staking the space.
FROM: Rosemarie, (727-562-4089)
DATE: 6/24/2004
NUMBER OF PAGES THIS MESSAGE (INCLUDING THIS PAGE): 2
Vinson Funeral Home 7Z79S41600 06122,104 02:Zapm P. 001
VINSON FUNERAL HOME
456 EAST TARPON AVENUE
P.O. BOX 1395
TARPON SPRINGS, FLORIDA 34688-1395
PHONE 727-937-6111
Important Facsimile
Please deliver immediately
FAX 727-934-1600
Attention: Tpe, Mac, P-.-
Company:
From:
Company:
?P
1 «?? Iii 5 ? e
o?
Number of pages including cover page-
COMMENTS:
C
??? c?i?y ? ?t? L? ?z?
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Vinson Funeral Home 7Z79341600
06rZ4104 08:17-am P. 00Z
VIII!!N!!'llllil!Illllill'll 11!11; ?!IIiIIIi,I IIII ?'' illllll!I I!III II!Illli!'ll;l l!i II IIII F UN -E T-?A L
'Illllllillllllllll{IIIIIIIII{11111{IIIIIIIIIIIIII
H 0 ML
June 23, 2004
City CleTk.'s Office
City of Clearwater
1. l.2 S. Osceola Avenue
Clearwater, Florida 33756
RE: interment of Anita L. Wilder Scearce
To whom it may concern:
1, Kimtrari Knight, granddaughter of the above named deceased, do hereby state that,
Anita L. Wilder Scearce is in fact the daughter and. heir of, Robert Franklin Wilder.
Kirntrari Knight, and ughter of Anita L. Wilder Scearce
State of Florida
County of Pinellas
The foregoing instrument was acknowledged before me this 23rd day of June, 2004 by,
Kimtrari Knight, who produced a Florida driver's license.
eft Dank,4 8 Vionon
# My Com il%iol DD077070
N Public -State of. Florida Decembers. coos
1>i.1nicl N. A:ir(°ntir'(i 11(mcrol Dirc(lo?r
Alfaro, Rosemarie
From: Alfaro, Rosemarie
Sent: Tuesday, June 22, 2004 4:51 PM
To: Dougall-Sides, Leslie
Subject: FW: Cemetery Issue
Importance: High
Leslie - I received another call from the funeral home, they wish to have the space staked tomorrow and the burial Friday,
June 25th.
They believe Anita to be the granddaughter.
Please advise.
Thank you.
Rosemarie
-----Original Message-----
From: Alfaro, Rosemarie
Sent: Tuesday, June 22, 2004 3:52 PM
To: Dougall-Sides, Leslie
Cc: Norman, Lois; LaCosse, Judith; Rhodes, Cecil
Subject: Cemetery Issue
We received a call from Vinson Funeral Home - requesting to inter a relative of the person who owns the space.
The actual space belongs to William J Wilder who was interred on 7/27/1914. The funeral home did fax a letter
that certified Robert F. Wilder and all his heirs the right to all of Lot "F" Block 3.
Will we need an Affidavit?
The name of the person to be interred: Anita Scearce
Vinson Funeral Home 7Z79341600 06/ZZl04 OZ:ZOpm P. OOZ
LI
5Lp 2- WDS?
TO Ta CITY OF CLtAl1WATUD FIMIDA
oat
TkUSTM OR COal MLLIN 10"D
OF
TM C>IRAlWABR CFMMTUT
This is to certify that an the fifteenth day of
rebmiry, 19641, the nnders4ped Mts. J. F. Clark,
Bowling Green, Florida, do arrant, give, and devise to
jobert F. Wildor,'Tatpon 8prinp, Florida, and his
hairs, all of Lot "Y" Block 3 Clearmter Camtery,
amept three Brave sites] one now ocoopied by
Villio J. Wilder, another one by YAxy Wilder Arnold.
and one reserved for 1. K. Arnold, 8t.
94ped ", ;; , q; L°P-AA?
14
BUTS OF FLOUDA
COUNTY OF ildRMZ
SaWwribed and sworn before ne on this
of 6 7 1964.
,r
Vitwases
C4-
Notary Public., c? Of Florida at Lark
MY I.ORIIIIi``..U11 I.:. 1un• Z3, 19u7
bonded by Air?erican Surety Co. of N_ T_
LL City of Clearwater, Florida
o Pater City Clerk Department
?- IT ''VWWJL Phone (727) 562-4090
Fax (727) 562-4086
FAX MESSAGE
TO: Leslie Dougall-Sides
LOCATION:
FAX NO.: 562-4021
COMMENTS:
FROM: Rosemarie Alfaro, (727-562-4089)
DATE: 6/23/2004
NUMBER OF PAGES THIS MESSAGE (INCLUDING THIS PAGE): 2
nson Fungal Home
5 Co .2?- '-? O 9 D
7279941660
-k) C ra (- . C.'\ 1-\<
06/22/04 OZ:Zapm
TO Tlllt CITY OF cr su?ATZIL, FLORIDA
QR
MWSTUS 06L OMMLLIN WAJW
OF
Ta CiSdRALfiR CMT6RY
lkis is to certify that on the fifteenth day of
Fobnmy, 19640 the ondersigued Mrs. J. F. Clack.
Ming Green, Florida, do grant, give, and devise to
llebost F, Wilder, 'T"Vm Springs o Florida, and his
heirs, all of Lst "F" Block 3 Clearwater Cantery.
esaspt three grave sites] one now oca *Led by
William J. Wilder. another one by lisry Wilder Arnold,
and me reserved for R. R. Arnold, Sr.
Signed ".;;.,d, BU
TZ OF FLORIDA
%AMM T OF Ham=
Subsoribod and scorn before se oo this dsy
of 1964.
Witnesses
h9Y ot ry
Public. ,?!? Of Floriffa at Larf;c
omnt;ss.nn I.;, ,;rc:; 1;1111 73, 14(,7
bonded by ilmencan Surety CO. Of N- Y.
?rf - ?. '?•a/ 3
FLORjADXEPA TMENTOF
HLT
A. (TYPE)
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
1. Name of First Middle Last Date Month Day Year
Deceased of
Ani i-n T.n,,i ca gnann no Death T- 71 7nn7,
2. Place of Death City, Town or Location
County
Pasco New Port Riche Name of
Hosp. or
Inst. (If neither, give street address)
Community Hos i a
of New o Richey
3. Name of Medical Address Phone Number
Certifier Andrew Fetchik, DO 2739 US Highway 19, Suite 225
Medical Examiner Physician Holiday, Flor:Lda 34691 727-944-3500
4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 456 East Tarpon rvenLie
Vinson Funeral 11omt Tarpon Springs, Florida 34689 166 727-937-6111
5. Check a. Ljy The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. F1 was contacted on
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that will complete and sign the medical
certification of cause of death within 72 hours.
c. El was contacted on He/she verified that
, Medical Examiner, will complete and sign the
medical certification of cause of death within 72 hours.
6. Funeral Director/ F.E. No./Reg. No. Date Signed
Direct Disposer Tlanipl R_ Vincnn?l - FR 9sll T„na 99 9f?(1/i
B. - BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 166-u4-(,
L? five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within
72 hours.
? No extension of time for filing tlae death certificate has been requested.
Registrar or Date Date Certificate
SubregistrarSignatur Issued: Jun-. 22 .G ;4 Due: Juiv 2s 2(104
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number:
Date
Medical Examiner, , gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is
required for all cremations.
Method of Disposition:
D
11 BURIAL ? STORAGE
FICREMATION ? OTHER (Specify)
Signature of Sexton
or Person-in-Charge
This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned
within 10 days to the local County Health Department in the county where disposition occurred.
CEMETERY OR CREMATORY Ciea7•waLer Ceaet :ry
Place of Disposition -. '; e", z .-; , 7.-, (; '
Date of Disposition June: 23 x004
Distribution: White: Cemetery or Crematory
DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer
(Stock Number: 5740-000-0326-2) Pink: Local Registrar
INSTRUCTIONS ON HOW TO COMPLETE THE APPLICATION
FOR BURIAL-TRANSIT PERMIT FORM
APPLICATION FOR PERMIT
Section A.
1. Type name of deceased and date of death.
2. Indicate place of death: County; City, Town, or Location; Hospital or institution (if not in hospital or institution, give street address).
3. Indicate the name, address, and telephone number of the Medical Examiner or physician who is to provide the medical certification of cause of
death.
4. Indicate name, address, telephone number, and license number of funeral home or direct disposal establishment.
5. a. Check if a completed death certificate, including the completed and signed medical certification of cause of death, accompanies the pink
copy of the application for Burial-Transit Permit to the Local Registrar of the county in which the death occurred. (If the completed
certificate cannot be obtained in sufficient time to be filed with the pink copy of the Application, check 5b.)
b. Provide the name of the person contacted in an effort to obtain the name of the physician who is to complete and sign the medical
certification portion of the certificate, and the date he/she was contacted. The person contacted must be either the physician or a
responsible person who can speak for him/her.
C. Check to indicate if this is a Medical Examiner case. Give the name of the person contacted who verified that the Medical Examiner will
complete and sign the medical certification of cause of death and the date contact was made.
6. Requires the signature of applicant Funeral Director, FE License number, or Direct Disposer, Registration Number, and the date the Application
was signed.
BURIAL-TRANSIT PERMIT
Section B.
If it is anticipated that the certificate cannot be filed within five days from the date of death, five additional days (exclusive of weekends) may be
requested and granted by checking the box provided. If no extension of time is requested, check appropriate box.
The Registrar or Subregistrar who issues the Burial-Transit Permit will sign and date the Permit Application and assign the permit number. Section
382.006, Florida Statutes, requires that a Burial-Transit Permit be obtained prior to disposition or removal from the State and within five (5) days after
death. It shall be mailed or delivered to the Local Registrar of the county in which death occurred within 24 hours after issuance. NOTE: It is not
necessary to wait until the Funeral Director/Direct Disposer has custody of the actual body to begin the paperwork.
AUTHORIZATION FOR CREMATION, DISSECTION, or BURIAL-AT-SEA
Section C.
Approval for cremation, dissection, or burial-at-sea must be authorized by the Medical Examiner. Space for his/her approval number and date are
provided. In addition, space is provided for the name of the person obtaining telephone approval from the Medical Examiner and the date such
approval was obtained.
(NOTE: DO NOT HOLD UP FILING THE PINK COPY WHILE AWAITING MEDICAL EXAMINER APPROVAL.)
CEMETERY OR CREMATORY
Section D.
Required: Signature of Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton.); check the appropriate box to
indicate the method of disposition; fill in the date and place of disposition in space provided