Reidy, Margaret F (Infant)•
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Cemetery Call Work Sheet
Date: -a-/ + /--Z
Funeral Home/ Monument Company:
Contact Name: /305 Wsadwct Ave. `50 1
Tel. #: qm, ( -, otl 01 Fax #:
Reason for call:
NAO-D
Deceased Name: ww1? fi
Date of Birth: Date of Death l / 1 ?l (o
Block Lot Aq Space
Owner of Plot:
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
$30.00 Staking Fee - received on:
Date of Burial: 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)
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