Title: Funeral Record for Daniels, Cassie
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Permanent Link: http://ufdc.ufl.edu/UF00039249/00001
 Material Information
Title: Funeral Record for Daniels, Cassie
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Daniels, Cassie ( 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: UF00039249
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.


FUNERAL SERVICE RECORD
rst)
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(Last)
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PLACE OF DEATH
COUNTY:


STATE:


(Middle)


(Name of Deceased)
OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNTYy/ dL,, /


NO. ///




STATE: /
/-/ -IfV. A


A l 'o F/ ov/, f
CITY OR TOWN; LENGTH OF STAY
IF OUTSIDE CORPORATE (in this place)
LIMITS, RITS R E "RURAL"'
,RIERuR, 1_____/_________________

FULL NAME OF LENGTH OF STAY
HOSPITAL OR INSTITUTION;
IF NOT EITHER, GIVE ADDRESS: // o i 4 r S
DATE OF (Mo h) (Day) (Year) (Hour
DEATH 6R -
SEX COLOR OR RACE MARRIED O NEVER MARRIED
/ l ?4#- / `1- E ] WIDOWED O DIVORCED (Specify)
DATE OF BIRTH AGE Months Days Hours Min.

USUAL OCCUPATION KIND OF BUSIN S OR INDUSTRY
. 1 ,,t A5 7" C- c /,7 I,, -;?
B'THPLACE (State or Foreign Country) CITIZEN OF WHAT COUNTRY?
0 rr0 Is //<.rr! I 2ATCNR
FATHER'S "

MOTHER'S MAIDEN NAME .
,94P 11t^ A1,16 Z f&A ->4


WAS DEL-ASED R U. S. ARE RCs


PRTATLe F1O NATION


INFORMANT

Address Relationship


CAUSE OF DEATH
AUTOPSY YES O NO r

PHYSICIAN

Address


CITY: RESIDENCE INSIDE
CITY 1 CITY LIMITS?
C A. YES.b NO E
STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION: C f' r Ct J YES D NO.q
Relationship Survivors




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____ 0y/A-e 0AL e/o; ; -
0/ 0. ,,l ,
"____ ICZ g- "' I ~, -

_____-- C\ ^' '< .y4' ^ w~ ^


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4 ZLet-i u "s e--, (24


CHURCH AFFILIAO ION -- '*r
pd CLERGYMAN
Address
FUNERAL PLACE
IF CHURCH DID BODY LIE IN STATF


YES [ NO E]O


DATE 7-- 7= TimeA 0


PLACE OF BURIAL Cremation or RePoval
Cemetery
Location
County


DATE
- 7 19


VISITING HOURS
FRATERNAL AFFILIATIONS


SERVICE -YES ---- NO [


State


CEMETERY LOT NO. Owner of Lot
Section Grave No. o
BEARERS







IMTFIPMATInNAL ASSOCIATION OF MORTICIANS


MUSIC YES O NO E
SINGERS



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


_ I _I__ ~~ ~~___1 _1


I_ I_ _


I JJ ........


_/n o a/ J a s r v ^#.b/ .
a9 4i/V7 a~ver ~^.. W A9. i. CIA


~---~


State~


>f-t~


(.
t
Apt


',




DESCRIPTION OF CASKET AND OUTSIDE ENCLOSURE


NO.


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 ......... .........
C clothing ................ .......





(2) ITEMS involving Cash Advances
Sales Tax ......... .. ........
Additional Autos .....
Cemetery Charges ................
Clergym an ........ .. .....
Telegram s ...............
Long Distance Telephone Calls .. ....
Transportation .......... ... .....
Flow ers . .. .. ..
Obituary Notices ..... .... .. ..







(3) ITEMS ORDERED LATER
Certified Copies ....... ... ...




CARRYING CHARGE


T erm s ............................ ....
. . . ..a. . . . . . .


Total (1).


Estate: Yes Q N o Q O ther:.......................................
Executor or Administrator .........................
Address .................................. ... ....
A tto rn ey. . . . . . . . . .. ... . . . .
Address
A. .


DATE


DEBITS


CREDITS BALANCE


_3 4Af I
-1 C 92,12


* -~J- I~ -


Total (2)






Total (3)


GRAND TOTAL


i . .


I--~--I;.. -. c-----sl r---r I----_







*(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 -----------------
...............................---
..................................

Total (1) L/7


*(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 ....... ----------
Additidhal-Autos --------------
Cemetery Charges -,..------- ~ a
Clergyman ------------------
Telegrams------------------
Long Distance Telephone Calls.--
Transportation---------------
Flowers --------------------
Obituary Notices .------------
.............................----.
..................................
..................................


Total (2) '


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


Total (3)
Grand Total


ORIGINAL


FUNERAL PURCHASE AGREEMENT


A. L. Cunningham, L.F.D. J. C. Cunningham, L.F.D.

PHONES: 622-7886 622-4251
524 BROADWAY, OCALA, FLORIDA


7- 3


Name of deceased MI 3 ?1A 5/.I ---D asaIAe(

Deceased is oA4 r- P of person arr
(Give relationship)


19Ai -

Age4V-

anging services


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

*(2-) Items Involving Cash Advances ...... $ 41F -

Total (1 & 2) $ClS- O

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


We agree to furnish all services, and I, or we, accept and approve the above
merchandise, indicated above.


SSignature of Purchaser


Address


City State


By /





Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Street City and State


Street City and State


Street City and State


Street City and State


1


L(


State


City




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