Notice of Interment

The Cemetery Office Charnwood Borough Council Southfields LOUGHBOROUGH LE11 2TT Telephone 01509 634704 Fax 01509 262370

NOTICE OF INTERMENT

PARTICULARS OF DECEASED

Full Names ______

Address ______

Age ______sex ______

Date of Death ______

Address at which death occurred ______

If a stillborn or a minor state names and residence of parents ______

PARTICULARS OF INTERMENT

Date of interment ______

Time of arrival at cemetery ______

Name of officiating Minister ______

PARTICULARS OF GRAVE SPACE

(a) New (b) Re-open (c) Purchased

Denomination …………………. Grave No.______Section_____

(A ) Grave (D ) Grave (Beamed ) Childs Cremated Remains

Whether grave has been selected ______

Whether any Monument Is erected ______

Date of last interment (if any) ______

Name of last person interred ______

Exact Size of coffin Length _____ft_____in Width ______ins EXCLUSIVE RIGHT OF BURIAL

Name of the present owner (Block Capitals)______(or executors) of exclusive right Signature ______

Grant of Right produced YES/NO

If answer to above is ‘NO’ an indemnity form must be completed and attached to this form.

If exclusive right has been purchased Name in which DEED should be completed______(Block Capitals)

Full address and postcode ______

Relationship of owner of exclusive right to deceased ______

GUIDANCE NOTES FOR FUNERAL DIRECTORS

The following points should be explained fully to the deceased family before completion of the interment form.

1. Exclusive right must be purchased before memorials will be permitted.

2. BEAMED SECTION

All concrete beamed sections in the Cemetery are lawned.

Graves will be tufted over as soon as possible after settlement and weather permitting.

As some sections are lawned for ease of maintenance no kerbsets, fences or grave surrounds will be permitted.

STATEMENT OF UNDERTAKER

I certify that the information given is correct and where necessary the following notes have been explained and understood by the deceased family.

Full Name and Address of Undertaker ______

______

Signed ______Date ______

PLEASE NOTE This notice completed and accompanied by required fees must be delivered to the Cemetery office 48 hours previous to time of interment. All arrangements for interments are subject to the Rules and Regulations made by the Burial Authority, copies of which are available from the Council Offices.

Forms:Interm