Title: Funeral Record for Jaules, John
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Permanent Link: http://ufdc.ufl.edu/UF00038355/00001
 Material Information
Title: Funeral Record for Jaules, John
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Jaules, John ( Estate )
Publisher: Cunningham Funeral Home
 Subjects
Subject: Funeral records
Registers of births, etc.   ( lcsh )
African Americans -- Florida   ( lcsh )
Spatial Coverage: North America -- United States of America -- Florida -- Marion -- Ocala
 Notes
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00038355
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: The Cunningham Funeral Records are part of the Department of Special and Area Studies Collections and its African American History Collections at the University of Florida Libraries.
Rights Management: All rights reserved by the source institution and holding location.

Full Text


RECORD OF FUNERAL

lyNo... .Date of Entry........ .......196.

S........................
9;,Widowed forced (What Race)
b l


Residence... ^L.; .-.. .(-Z~ *
Charge to 2 2. ..............
Address... ..... .......... ......
Order given by.. ;2 ... .. ........
How Secured.... .. .. .. .....
If Veteran, Name of War/..... .L ..........
Occupation ...... ""................. T ........
(Soci security Number)
Employer and Addss ... C.... ..
Date of Death.... ./// .( ... .........
--') (Day) g (Yr.) (Hour)
Date of Birth.... .Age ...........
.) (Day) (Yr.) (Yrs.) (Mos.) (Days)
Services at.... ....... .........
Clergyman... f /.. .
--- *** d dress)
Religion of the Deceadd.. ..............
Birthplace ...... .,. .... .... ........
Resided in the State.. ...................
0y S ty or Coun )Years) (Months)
Place of Death.. "C .. a..... ... ...
Cause of Death:. ..... ....
Contributory Causes...................................
...A.............. ........ ... .....
Certifying Physician.. '1. ....-
Cr
His Address..... .. .........
Name of Father..... .. .. L... .......
His Birthplace. ..... ...., .-.A .........
Maiden Name of Moth..
Her Birthplace ..... .. .............
Date of Funeral... 3-. ......... .
(Date) -, (Day of Week) (Hour) f
otor Remains to.... -2 e? ....... ..........
Ship .j 7Crt7Ir)
Size of Casket..... .. .. ie r .......
SaColor and Nube
Manufactured by............... ..................
Cemetery }
Crematory J f ********************************** *
Lot No.................
Grave No ................
SSection No................
: Block No......... ......

Diagram of Lot or Vault Owner.................
Miscellaneous.......................................
................ ............................... .....


or............................ of Age of Husband or Wife (if living)................... Years

Complete Funeral (except outlays)........... $ 'j i
Casket. .................................. ............
Burial Vault or Box................... .......... .......
(State Kind)
Embalming Body .................. .................
(Name of Embalmer)
Barber, $.......... Hair Dressing, $........ ............
Dressing Body, $......... Underwear, $............ .....
Suit or Dress ............................... ....... ......
(State Kind and Color)
Slippers, $ ............ Hose, $............ ...........
Folding Chairs, $ ......Tarpaulin, $ ........ .............
Candelabrum, $ ........ Candles, $ .......... .............
Door Spray, $.........Gloves, $............ .............
Funeral Car, $....... Ambulance, $......... .............
Limousines to Cemetery... $...... .............
Extra Limousines ..........@ $............ ........
Autos to R. R. Station.......@ $......... .............
Getting Remains from ...................................
Taking Remains to ..................... ............. .....
Trip to Coroner's Inquest ................... .............
Delivering Box to ......................................
Deliver Flowers to....................................
Removal Charges .................. ......... .......
Procuring Burial Permit ............... ..............
(State Number and District)
_Certif.Copiesof Death CertificatesNo. ......
(State Physician's or Coroner's)
Pall Bearer Service, $.... Use of Chapel, $.....
Gross Total for Sales Tax...................$ .............
Outlay for Lot............................. ....... ......
Cremation ........................ ......................
Flowers, $.....Palms, $..... Matting, $..... .............
Rental of Tent, $.... .of Temporary Vault, $ .... .............
Opening of Grave or Tomb .................. .............
Lining Grave, $...... Lowering Device, $ ...... ..... .......
/Outlay for Shipping Charges ................. ...... .....
Clergyman, $..... Singers,$.... Organist, $..... ....... ......
Railroad $ Aero-
or Motori}Tckets, $ ........ plane Service,$..... .............
Telegr., Phone, Cable or Radio Charges ........ ............
Cash Advanced .......................... ...... ......
Out of town Funeral Director's Charges....................
Personal Service ........................... .............
. ....................,............... I .. .............
....line Death Notices in......Papers ....... .............
......... .. "~~..a.......... )..... .......... .. ..... .. ""
Names Newspapers)
..... ... .. ....................... .. .
.. s. "j a ^.................. r.--
Sales Tax .................................
Total Footing of Bill.....................$ $.2. .3.
Less................................... $ -15
Balance..............$ ..
Entered into Ledger, page..... or below.
Miscellaneous........................................
r-.".


Date Amount Paid Balance Date Amout Paid balance

5'.... ToAbove Balance...... .. To Balance Forward.... ....... ...... ...........
. ....- .By ayment.............. $... .7 3 $. .. ............. By Payment......... ....... ...........
.......... ... ........... .............. ............... ....... ....... .... $ ....... .. ......
........ .... ........... $ ..... ... $............................... ........... ....... $....... $ ...
...... $...... .. $....... ..... $........$.......
........... .. a" ....... ... ....... ...... ..... .................... . .. $ .................
Names of Insurance
Insurance $........................Lodges..........................................Companies....................................
I hereby authorize the above Funeral, and I hereby represent that I have sufficient resources Legally available to..................................
(Firm Name of Funeral Directors.)
for the payment of aforesaid sum, and I hereby covenant and agree to pay the same within................... days from date. Interest to accrue from
maturity at the rate of ............% per annum. Signed.....................................................

Witness ............................................... Address...... ..........................................
Revised by W. W. Feineman, Long Beach. California


Total No....
Name of De


__r_~ __ _1 __ __




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