INTERMENT APPLICATION

Details of Deceased:
Fullname : _____________________________________________________
Address : _____________________________________________________
_____________________________________________________
Age at Death : _____________ Date of Death __________________________
Spouse : _____________________________________________________

Details of Plot Owner

Fullname : _____________________________________________________
Address ( if Alive) : _____________________________________________________
write DECEASED if deceased) _____________________________________________________
Relationship to Deceased : _____________________________________________________
Section : _____________________________________________________
Plot Type : ___________________ Lot No. _________ Plot No. __________

Details of Applicant
Fullname : _____________________________________________________
Address : _____________________________________________________
: _____________________________________________________
Relationship to Plot Owner _____________________________________________________

Funeral and Interment Details

Name of Funeral Home : _____________________________________________________
Contact at Funeral Home : _________________________ Tel. No. ____________________
Date of Interment : _____________________________________________________
Time of Interment : _____________________________________________________
Remarks : _____________________________________________________
_____________________________________________________
_____________________________________________________

Form Details:
Date Paid : ________________________ Amount : ___________________
Official Receipt No. : ________________________

Approved by:

____________________________
SIGNATURE OF APPLICANT OVER PRINTED NAME _________________________________________

INTERMENT PERMIT Received by: _________________________

 ST. MARY ETERNAL GARDENS

DIGGING PERMIT

To: Juryl S. Gatia Date: August 15, 2023

This is to authorize digging for burial listed lot(s) below.

SECTION LOT NO. OWNER BURIAL DATE TIME

1. FATIMA F-014-33 GUADALQUIBER, CHARAGIN Saturday, August 19, 2023 9:00 AM

2.

3.

Prepared by: Checked by:

Catherine Capilitan Maria Cardenio

 ST. MARY ETERNAL GARDENS

INTERMENT PERMIT

To: JURYL S. GATIA Date August 18, 2023

Please be informed of the approval of interment application of CHARAGIN A. GUADALQUIBER

Below are the details. Please check.

F-003-01 GUADALQUIBER, CHARAGIN ANTONIO AMAMIO Saturday, August 19, 2023 9:00 AM
LOT NO. LOT OWNER PERSON TO BE INTERRED BURIAL DATE TIME

Prepared by: Approved by:

______________________ ________________________
Catherine S. Capilitan Maria S. Cardenio