<p> The Cemetery Office Charnwood Borough Council Southfields LOUGHBOROUGH LE11 2TT Telephone 01509 634704 Fax 01509 262370</p><p>NOTICE OF INTERMENT</p><p>PARTICULARS OF DECEASED</p><p>Full Names ______</p><p>Address ______</p><p>Age ______sex ______</p><p>Date of Death ______</p><p>Address at which death occurred ______</p><p>If a stillborn or a minor state names and residence of parents ______</p><p>PARTICULARS OF INTERMENT</p><p>Date of interment ______</p><p>Time of arrival at cemetery ______</p><p>Name of officiating Minister ______</p><p>PARTICULARS OF GRAVE SPACE</p><p>(a) New  (b) Re-open  (c) Purchased </p><p>Denomination …………………. Grave No.______Section_____</p><p>(A ) Grave  (D ) Grave (Beamed ) Childs  Cremated Remains </p><p>Whether grave has been selected ______</p><p>Whether any Monument Is erected ______</p><p>Date of last interment (if any) ______</p><p>Name of last person interred ______</p><p>Exact Size of coffin Length _____ft_____in Width ______ins EXCLUSIVE RIGHT OF BURIAL</p><p>Name of the present owner (Block Capitals)______(or executors) of exclusive right Signature ______</p><p>Grant of Right produced YES/NO</p><p>If answer to above is ‘NO’ an indemnity form must be completed and attached to this form.</p><p>If exclusive right has been purchased Name in which DEED should be completed______(Block Capitals)</p><p>Full address and postcode ______</p><p>Relationship of owner of exclusive right to deceased ______</p><p>GUIDANCE NOTES FOR FUNERAL DIRECTORS</p><p>The following points should be explained fully to the deceased family before completion of the interment form.</p><p>1. Exclusive right must be purchased before memorials will be permitted.</p><p>2. BEAMED SECTION</p><p>All concrete beamed sections in the Cemetery are lawned. </p><p>Graves will be tufted over as soon as possible after settlement and weather permitting.</p><p>As some sections are lawned for ease of maintenance no kerbsets, fences or grave surrounds will be permitted.</p><p>STATEMENT OF UNDERTAKER</p><p>I certify that the information given is correct and where necessary the following notes have been explained and understood by the deceased family.</p><p>Full Name and Address of Undertaker ______</p><p>______</p><p>Signed ______Date ______</p><p>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.</p><p>Forms:Interm</p>