Title: Funeral Record for Young, Rosa
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Permanent Link: http://ufdc.ufl.edu/UF00039037/00001
 Material Information
Title: Funeral Record for Young, Rosa
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Young, Rosa ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1961
 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
General Note: Cunningham Funeral Booklet Entry #917
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00039037
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
BURIAL PERMIT NO.


(Last)
6 (I&Ov


PLACE OF DEATH
COUNTY:


FUNERAL SERVICE RECORD


(First)


(Middle)


(Name of Deceased)
OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNTY > / -


CITY OR TOWN; LE GTH OF STAY
IF OUTSIDE CORPORATE (in this place)
LIMITS, WRITE RURALA place


L LUF NAME OF
HOSPITAL OR IN N


LENGTH OF STAY


IF NOT EITHER, GIVE ADDRESS: / i

DATE OF (Month) (Day). f (Y pr) (Hour)
DEATHa A '
SEX COLOR OR RACE MARRIED [ NEVER MARRIED
DC'/v/',/edAl /I//[ OWIDOWED D DIVORCED (Specify)
DATE OF BIRTH AG Months Days Hours Min.

USUAL CCU ACTION KIND OF BUSINESS OR INDUSTRY

BIRTHPLACE (State or Foreign Country) CITIZEN OF WHAT COUNTRY?
./9 ,L e ^.'I, _
FATHER S/NAME

M R'S MADE ME.

WAS DECEASED EVER INU. S. ARMED FORCES?
INFORMAN I .PRIVATE INFORMATION
INFORMANT ///j / 7 'I

Address Relationship
ecr- If 1- C /yzS CAJ

CAUSE OF DEATH
AUTOPSY YES C NO C

PHYSICIAN f'- '. '. -_-.

Address

PLACE OF BURIAL Cre~ion orRemoval DATE
Cemetery 0
Location
County State

CEMETERY LOT NO. Owner of Lot


Section
BEARERS


Grave No.


I


INTERNATIONAL ASSOCIATION OF MORTICIANS


NO. ?/7


STATE:
Zl/"


__~_ ~___~ ___~~~__ _.___


I -


1


-- .%.- ---%m


STATE:


CITY: RESIDENCE INSIDE
J a CITY LIMITS?
c -e f4 YES L NO E
STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION: YES O NO E
Relationship Survivors

























CHURCH AFFILIATION
CLERGYMAN
Address
FUNERAL PLACE
IF CHURCH, DID BODY LIE IN STATE YES O NO O
DATE Time
VISITING HOURS
FRATERNAL AFFILIATIONS __ -_ SERVICE_..YES .----NO O




MUSIC YES E NO C
SINGERS



FUNERAL DIRECTED BY LICENSE NO.
EMBALMER'S LICENSE NO.
REMARKS:




DESCRIPTION OF CASKET AND OUTSIDE ENCLOSURE


Purchase Date Size Our Number Interior No.
Mfr. Mfrs. No. Material Material
Casket Cost Blanket Cost Cover Finish Color
Kind of Vault Type of Vault Finish Cost
SALES RECORD STATEMENT MAILED LEDGER LETTER SENT


(1) SERVICES, including casket
All Facilities and Equipment ....
Personal and Staff Service ..
Professional Service .
Visitors Register ..
Acknowledgement Cards
Funeral Sedan ..
Casket Coach .. ..
Outside Enclosure .. .. ..
Clothing ........... .. ..


I


Total (1)


(2) ITEMS involving Cash Advances
Sales Tax .... ...
Additional Autos
Cemetery Charges ........
Clergyman ...........
Telegrams ...
Long Distance Telephone Calls
Transportation ..........
Flowers ....
Obituary Notices ....... ..


(3) ITEMS ORDERED LATER
Certified Copies ..


Total (2)



Total (3)


CARRYING CHARGE
GRAND TOTAL
T erm s ... .. .. ... ... ... ... ... .. ... ...
.....Purchaser.... ........................... ..........................
Purchaser


*1


Estate: Yes D No O Other: ................................
Executor or A dm inistrator ............................................
A address .... .....................
Attorney ...........................................................
Address ... ............................. ...........................
__________ -fl


DATE


RI _E I -


- U-~4 I


NO.


~~~


............................................ ~ "I


CREDITS


BALANCE


DEBITS


. . . . . .


. . .













0


*(1) SERVICES, including Casket
All Facilities and Equipment
Personal and Staff Service
Professional Services
Visitors' Register
Acknowledgment Cards
Funeral Sedan
Casket Coach
Outside Enclosure '---------
Clothing -* / _*-'
Clohin----------------------------- -



Total (1)

*(2) ITEMS INVOLVING CASH ADVANCES
To Permit Us To Render A Better Service
We Have Advanced The Money On These
For Your Convenience.
Sales Tax ---------------------
Additional Autos ..--------... .--
Cemetery Charges ---------_--
Clergyman---------------------
Telegrams -------- --------------
Long Distance Telephone Calls.-- .--
Transportation ---------------..
Flowers / --------------
Obituary N ces ..-.------

( / / __


--~ ---;----------- ~
_--_ _

Total (2) _

*(3) ITEMS ORDERED LATER
Certified Copies -----------------



..................................



Total (3)
Grand Total


Name of decea

Deceased is


based


;t: *


FUNERAL PURCHASE AGREEMENT 1001
TRIPLICATE

eannihf "'s qiwweal o4ame
A. L. Cunningham, L.F.D. J. C. Cunningham, L.F.D.
PHONES: MA 2-7886 MA 2-4251
524 BROADWAY, OCALA, FLORIDA


/ -/-' of person arranging services
(Gie relationship)

*(1) Services, including merchandise .......$ .

*(2) Items Involving Cash Advances .......$ '.

Total (1 & 2) $7 0


*(3) Items ordered later .................. .$
Both parties agree any items ordered later
shall become a part of this agreement and
shall be inserted therein.


Grand Total $/ -

C..-- i-'/^C J ^ ^,


Terms of PavMent~c


Legal rate of interest after maeity.


We ag to furnish all serve es, and
merc dise, in ed a e


J


/


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


I, or we, accept and approve the above



Signature of P ase /1.( 1
/< /4'4,


State


dress


Street City and State


Street City and State


Street City and State


Street City and State


I.



*..* '-


19e -

Age -


. _I ~_I_ I_


/


Tem of Pavm


7~












File Number

/
Payment Received in Full /

Individual Payments Received as follows:


DATE
PAYMENT DEBIT CREDIT BALANCE
RECEIVED DUE

^^>(fi ~^ ^^I~ ~ ~


DATE
PAYMENT DEBIT CREDIT BALANCE
RECEIVED DUE


19




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