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Coachman, B. G. .l.___.. ~, '. Owner J cbAf~ Address: Deceased name' Date of birth: Date of death Funeral home Director/phone: Legal descripti St aki ng fee: I~J/:'/f8 TI Staking fee required Cemetery attendants hours 7:00 am -- 3:30 pm; fees paid after these hours will not be called over until next working day.No caretaker on duty on holidays. 'dd q/h3 ai~ G .JJ ~.C./l7(~ - ,. C ~.~i' #1 .) ~ -:Q"J" ""'0 cu.~-, ~~4A.1 ~ cO ~ I ~~Ii;?~,-J I\.u(}-~< ~,~' ~ J.,ut:;;!,Lp ft, kZ ~ MJ.~ 1v ~ .~ ~t ~ p~~ L~tl~/ ~ ~l ~~ ~ \~~ IA--- ~---t::;;J (1J..~~~ ~~/l>r}_1J1 ~J~ ~t.. ) ~.2.3 J ' Before me, the undersigned authority, personally appeared James H. Martin who being duly sworn says under oath the matters and facts set out above are true and correct to the best of his knowledge and belief. Sworn to and subscribed before me this 6th day of December A.D. 1988. a#i;~~ ~tc&j."ll~; :~=~G ~I:;;:;.~ .... - -:::: "- .... c...;;.~ ~ --, ."~..' .-2 -, ...,....,~:-lO!' iOr.;JnN:;:i' ~.;':',.1.7 ,,-. Iond.d~u ,r,.."I..ljo, lniui~~ ~. " [ . CEMETERY CHECK LZST' ! r.- PURCHASE OF CEMETERY LOT Owner's Name ;8. ):J, ~~ Address DATE /t?</ S-/J?:P ~I County (if other than Pinellas) Block -3 Lot I '-~ space~~I~ of Space .$ ~ Cost Receipt No. _Purchaser signed' "F Interest in Florida Give Purchaser copy Deed Prepared Deed signed & sent _Copy of Deed file Original deed m _Necessary information entered in Cern $ Return for Transfers of (in Cemetery file drawer) cover letter (large green book) ~~~ ItftJS-/f?? INTERMENT ~~led out Cemetery Information Sheet ~V~ifY ownership in Cemetery Plat Book ~eceived $15 staking fee & issue receipt (include deceased's name and 5Pe block, lot & space on the receipt) ~I~ue Burial Permit ~all Bob Maute at 6588 (Faye at Public Service Dispatch) & leave message for him to return call. When he calls back, give him name of deceased, block, lot & space, and date & time of service. fJ~Fill in proper line in Plat Book ~Fill in proper space on Master Map (in Plat Book) ~nter deceased's name in Cemetery Index ~ 1 ~ jot~#f Cemetecy Information Owner Address: Deceased name- Date of birth: Date of death Day/time service: Funeral home Director/phone, ~ Legal descriPtion~l~ jJMd~<? r.j t16 - 3CJ5S- Lot Space Staking fee: Staking-LeedrequLred minimum -12hrs prior to service. Cemetery attendants hours 7:00 am -- 3:30 pm; fees paid after these hours will not be called over until next working day.No caretaker on duty on holidays. t;J 0~.v~ Udt7 tJi 55 q.-- ~ ~~.2~- .-tc t:.~ ~/~-j-~~d ~"!f ~ /VcY~ ~