Cemetery Record Form

Deedholder Name*

(IMPORTANT: this would be the name of the person who originally purchased the plots, for example, a grandparent who may not have the same last name of the deceased.)
Name of Deceased
First Last
Year Deceased*
MM slash DD slash YYYY
Names of others buried in the plots:
Please provide any other information that can help us locate these records.
Please provide your contact information, in case we have any questions.
Phone*
Email*
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