Title: Funeral Record for Roberts, Norah
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Permanent Link: http://ufdc.ufl.edu/UF00038357/00001
 Material Information
Title: Funeral Record for Roberts, Norah
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Roberts, Norah ( 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: UF00038357
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

Total No... .' Yearly No.... .. .... Date of Entry..... .i'/?^-............19....
Name of Deceased.... -.. ........ 4A. '. y R Married 0 Single D Widowed E Divorced ( (What Race)
Residence.&. .. /. ..S.. ( ^ .[. H.. OHusbandOwifeCeWidow
Ch r g \e or ........................... of ) Age of Husband or Wife (if living) .................. Years
Charge to... ./ .. ..' ..... ......, .,.. ...
/ /1 Complete Funeral (except outlays)...........
Address............ C ............................... ".
Casket ................. ................ ....... ......
Order given by.... .... ( ............... Burial Vault or Box ..................................
(ori (State Kind)
How Secured..... .. ...&... '. .,......... Embalming Body .................... ...... ......
(Name of Embalmer)
If Veteran, Name of War......../ /..;............... Barber, $...........Hair Dressing, $........ ...........
/ Dressing Body, $........ Underwear, $...... .............
Occupation..... ........................ Suitor Dress........................................
(Social Security Number) (State Kind and Color)
Employer and Address ............ .............. Slippers, $.............Hose, $...........................
Date of Death... .. .. Folding Chairs, $......Tarpaulin, $.....................
(Mo.) (Day) (Yr.) (Hour) Candelabrum, $....... Candles, $.......... ........ ......
Date of Birth..... 3.... ...3e .Age .,. ............ Door Spray, $.........Gloves, $ ................. ......
(Mo.) (iay (Yr.) (Yrs.) (Mos.) (Days) Funeral Car, $....... Ambulance, $..... .................
Services at... W.4/.: /../.. /C-. 4... ........ Limousines to Cemetery..... @ $ .......... .............
Clergyman................................... ... Extra Limousines ...........@ $....... ......... ......
(Address) Autos to R. R. Station...... @ $........... .............
Religion of the Dec sed.../? ,......................... Getting Remains from ........................ ..........
Birthplace ..... A. .. ............................. Taking Remains to ................. ...........
Trip to Coroner's Inquest .............................
Resided in the State .................................. Delivering Box to .............. ...... ............
(or U. S or City or County) (Years) (Months) D .
Place of Death..1 ..- 9._f .1.(. :........... Deliver Flowers to.......................... ....... .....
Placeof Death..... ........... Removal Charges.......................... .............
Cause of Death ...................................... Procuring Burial Permit ............ ....... .........
(State Number and District)
iCertif.Copiesof Death CertificatesNo. ......
Contributory Causes. .................................. (State Physician's or Coroner's)
Pall Bearer Service, $.... Use of Chapel, $.....
..................... ..... .... Gross Total for Sales Tax....................... ...... ......
Certifying Physician... S.4 (... ... ....... Outlay for Lot ............................. .............
(or Coroner)
His Address ........ .. ... ..... Cremation............................................
His Adress. ..~. ;.. ...*... Flowers, $.....Palms, $. Matting, $..... .............
Name of Father..... P. ./v.... ... .... ...-... Rental of Tent, $ ... .of Temporary Vault, $................
His Birthplace................... .................... Opening of rave or Tomb .............. .............
S....- Lining Grave, $..... .Lowering Device, $ ..................
Maiden Name of Mother.../ .i A.r. /... d 11 I/ W..... Outlay for Shipping Charges ............... ............
Her BClergyman, $..... Singers,$.... Organist, $..... ............
Her Birthplace.. ........... ........ ...... Railroad. ....... Aero-
Date of Funeral.... .... ... or7 MotorTickets, $........ planeService,$...............
(Date) (Day of week) (Ho Telegr., Phone, Cable or Radio Charges ........ ............
Motor Remains to... .......................... Cash Advanced ........................................
Size of asket.... ........... Out of town Funeral Director's Charges....................
ize(Stat o. ( randNum r Personal Service........................... .............
M manufactured by ..... ........................ . .*.r **. .. ... ......... .. ... ...
Cemetery ..... line Death Notices in......Papers ....... ...........
Crematory j *** *********** **** .... .. ............. ......... .. .... ... ....
(Names of Newspapers)
Lot No................ .. ....................................... ............
Grave No.. ............. *..........................................
Sales Tax ........................... ......
Section No................ --t SectionNo............. Total Footing of Bill..................... $ .. ......
Block No......... .......
BlockNo......... Less....................................$ 4 06
Diagram of Lotor Vault Owner................. Balance .............$ I..
Miscellaneous......................................... Entered into Ledger, page......or below.
..................................................... M miscellaneous ................. .........................


Date Amount Paid Balance Date Amount Paid Balance

.Y.~... A....'. To Above Balance...... .. .. ....$. .... To Balance Forward........... ..... $....... ......
.......... ... By Payment........... $.... ......... $....... ...... ......... ByPayment........... $...... .. ... ............
a a ....... ............. ......... .......... ...... ....... ......
.......... .... ....... $... ... .. ..... $... ..... .... .. ........ $... ... $...... .. ....
.............. .......... .... .. $..................... .... ..... ....... .........
............ ... .... .. ....... I .... .. $..... ...... I .......... I .... I ........... Is ....... I ...... .......
Names of Insurance
Insurance $............. ...... Lodges .......................................... Companies...... .......... ..... ..........
I hereby authorize the above Funeral, and I hereby represent that I have sufficient resources Legally available to. t, r .......
(irm Name of Funeral sectors )
for the payment of aforesaid sum, and I hereby covenant and agree to pay the same within...... .........days from dat. In rest to accrue from
maturity at the rate of...........% per annum. Sized.
Signed.... .... .................. .................
Witness .'.. ..-W.... ...... Address......... ............ ..............................
r Revised by W. W. Feineman, Long Beach, California




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