Schneidereit, Judy
WeJJUJoo~o FarleRaJ Holllft eEl \7 ED
16931 U.S, Highway 19 · Hudson, Florida 34667
Pasco (813) 863-5471 · Hernando (904) 683-1702
Florida 1-800-262-1132
SEP1 5 1988
Attion (en1er
SEPTEMBER 9, 1988
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CITY OF CLEARWATER
POST OFFICE BOX # 4748
CLEABl<l1\'I'E:R, Yl,O_RJDA 34618..
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ATTN: ACTION CENTER, SARAH BROWN
DEAR SARAH BROWN,
THIS IS TO INFORM YOU THAT I ,J'trfIJr"'SCPlNETOOttErT, < HEREBY GRANT THE
INTERMENT OF GERTRUD EBERELEH IN SPACE~ LOT 42, BLOCK 16, IN THE
CITY OF CLEARWATER CEMETERY. THE DEED IS CURRENTLY IN MY NAME AND I,
JUDY SCHNEIDEREIT, HEREBY GRANT PERMISSION FOR THE INTERMENT.
SIGNED
.J-
STATE-O~.o.FLORIDA
COUNTY OF' P-ASG.O
NO~~RY-PU~L;~~ 1.
Notarv Public, State of Florida
My Commission Expires March 13. 1992
lDndecl nw r'01 fQiAolalura IaI.
,
IN AND FOR PASCO COUNTY, FLORIDA
BEFORE ~ffi, THE UNDERSIGNED NOTARY PUBLIC IN AND FOR SAID COUNTY AND STATE, ON
THIS DAY PERSONALLY APPEARED JUDY SCHNEIDEREIT KNOWN TO ME TO BE THE PERSON
WHOSE NAME IS SUBSCRIBED TO THE FOREGOING INSTRUMENT, AND ACKNOWLEDGED TO ME
THAT SHE EXECUTED THE SAMD FOR THE PURPOSES THEREIN EXPRESSED. GIVEN UNDER MY HAND
AND SEAL OF OFFICE THIS 12TH DAY OF SEPTEMBER, 1988.
Mo()eRn SeRvice wit;b TRa()it;ionaJ Dignit;y
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September 1, 1988
Ronald D. Sewell
Wellwood Funeral Home
16931 U.S. Highway 19
Hudson, Florida 34667
Dear Mr. Sewell,
Please complete the enclosed Burial Permit Information sheet and return it as
soon as possible. We need this information to complete the burial permit.
Once we receive this information we will be able to contact you with the date
the grave staking will take place.
If I can be of any further assistance please do not hesitate to contact me at
462-6900.
Thank you,
Sarah Brown
Acting Public Information Supervisor
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WeJJrvoo'() FarleRaJ Horne
16931 U,S. Highway 19 · Hudson, Florida 34667
Pasco (813) 863-5471 · Hernando (904) 683-1702
Florida 1-800-262-1132
CITY OF CLEARWATER
POST OFFICE BOX #4748
CLEARWATER. FLORIDA 34618
ATTN:ACTION CENTER
DEAR SIRS:
ENCLOSED PLEASE FIND CHECK IN THE AMOUNT OF $15.00. STAKING FEE.
PLEASE NOTIFY THIS OFFICE WHEN GRAVE HAS BEEN STAKED.
THANK YOU, ._
A ::,,.1.( -<A.)"': YlI
RONALD D. SEWELL
FUNERAL DIRECTOR
ENCL: CEMETERY DEED
Mo()eRn SeRvice wit:b TRo()it:ionoJ Dignit:y
--
DePARTMENT OF HE^I.TIi N<<>
REHABlLlTA"vE Sl::RvIU'..s
STATE OF FLORIDA
DEPARTMENT OF !'iEAL TI-;I & REHABILITATIVE SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL_TRANSIT PERMIT
,
A.
1. Name of
Deceased
Middle
Last
DATE
OF
DEATH
Month Da~'o Year
GIITIUJ)
IRIGUD
EB~I.JPI
AUGUST 24.. 1988
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
H.ERlWmO BIOOlSVILLE Inst. BCA - ()AI BIU. HOSPITAL
3. Name of Medical II Physician Address RLImll 3if613 Phone Number
Certifier ROBERT E. EBERT, H.D. 0 Medical Examinerll371 CIJUS R1J.~ ~lllE en) ~lOftO
4. Funeral Home/ Name, Address Phone Number (Area Code)
~V~~D FUNEIW. IDfE 16931 U.S. 19 1IlJDS<>>I. FLORIN 34661 (813) 863-S4i'l
5. Check a 0 The medical certification has been completed and signed. A completed certificate of death ac:companies
Appro- this application.
priate jf, Di. DoO,o....- E. tl'D1TD'It'S OFFI~ (I"'DUVI7A) 8-25-88
Box b 1::.1 Ai :w.:aIU ~OIU 'WID wallO.,. was contacted on within 48
hours after death. He/she verified that this .,S UO~I c\L~' that there was no accident nor
other external_~a_lJs~_of death.andthat_ .. _.' _ ..... _ · . ,v\/~1I complete
and sign the medical certification of cause of death.
c 0
was contacted on . He/she verified that
, Medical Examiner, will complete and sign the
Fla. Lic. NojReg. No.
n 24.20
Date Signed
AUGUST 25.1988
6. Funeral Director/
B&~~
B.
Permit No. WFHl~13-1357
Permission is hereby granted to dispose of this bo(:iy.
o A five day extension of time for filing the death c .. lusive of weekends) has been requested and granted. If it cSlnnot be filed
within this time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the County in which death oc-
curred.
I!I No extension of time for ring th. Zd ~h certificate. que$ted.
Registra~ or . I 'r., Date 25 1988 Date Certificate
Sub'Reglstrar Signature . ,..; -';'< -I. Issued:AUWST. Due:
C. AUTHORIZATI.ON for CREMATION. DISSECTION or BURIAL-AT -SEA
. . OK'D BY PHONE ,I) G J. b /98'}-
Signature . MEDICAl EXAMINERS . , Medical Examiner Date U. "..
or ~ ("""LJ;I;' /'.A;tA:;A- ~ ;/f.r /1~~~"""t '. (! ,_'~
Medical Examiner . OC-';V"':>'7 1,,1'7' rl'T()J'7 , gave authorization by telePhon~(....Vq,. J..IUj. ";/I117/T.
Funeral Director/Direct Disposer. Date (/6;).G. /93" f" ~
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.
D.
FOR FUNERAL DIRECTOR/DIRECT DISPOSER USE ONLY
1. Date Burial-Transit Permit (pink copy) was filed with Local Registrar:
2. Date Temporary Certificate was filed with Local Registrar:
3. Date complete Certificate was filed with Local Registrar:
4. Follow-Up Efforts & Activities (Note parties & dates contacted):
5. Funeral Director/Direct Disposer Report filed: Yes_No_. Date Filed:
FUNERAL DIRECTOR/DIRECT DISPOSER COPY
HRS Form 326. May 86 (Repla~es Apr 81 edition which may be used)
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CREMATION
AUTHORIZA TION
C, No.
Permit No {.L.IF H- \:B3 - j 35
oa'el}\Xl~ JS '9~
A II Suncoast Crematory
1100'7 l'.S. HIGHWA \' 19 · H~dson. rwRlDA 33567
TELEPHO"[ (1l1~1168.9537
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The underSigned hereby reQuest! I"d Cl..Jthor ize! In Clccorpal'\ce with and wbject to your rules and regulations as
we:l!t those 01 the S~te 01 F I~ridao to cremate the remains and ~... skE:t containing UmE: 01 . .
_~'l-~R.1 \-.V~ ~?~\~~ whod,edal /~ ~('fl: - OG...tC..~l.:.u... t4t.,;')p.
01" the ~daY 01 Au{,,,,-..:..* . '9~, hour I. 1\ . ':;)"1 fYl'\. agE 77 and certifies and represents
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thO! h. or .h. hOI the right to 1II0~. IlIell outhorilOllon fJft.~ -er... te hold the Cr.lllotorlum, Flln.ro: Ho",.ond
Funera' Director harmlell from liability on account of .aid authorization 'ormillion it ol.p granted for
of . pecemaker ~
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RECEIVED
SEP 8,988
Action Cegf'GJ"