Title: Funeral Record for Thomas, Hattie
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Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00039372/00001
 Material Information
Title: Funeral Record for Thomas, Hattie
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Thomas, Hattie ( 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: UF00039372
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_



. PLACE OF DEATH
COUNTY:

2// a/ A ii Xr /^


STATE:

I N*vlf


CITY OR TOW LENGTH OF STAY
IF OUTSiDE COR R ATE 7 (in t is place)
LIMITS, WRITE "RURAL":
FULL NAME OF LENGTH O STAY
HOSPITAL OR INSTITUTION;
IF NOT EITHER, GIVE ADDRESS: /
DATE OF Month) (Day) (Year) (Hoe)
DEATH )W &4 /L,1 /9 .

SEX A WIDOWED DIVORCED (Specify)
DA OF IRTH AGE Months Days Hours Min.

USUAL OCCUPTIN KIN U OF BUSING OR INDUSTRY

BIRTHPLACE (State or Foreign ntry). CI WHAT COUNTRY?

FATHER'S NAME
MOTHER'S MADE J- ,
AS DECEASED E IN. S. ARMED FORCES?

INFORMAN!, )
Address Relationship -t .


CAUSE OF DEATH
AUTOPSY YES O NO O

PHYSICIAN ,& / lU

Address
S PLACE OF BURIAL Cremation or Removal ATE
Cemetery 194 __3
Location
County State
h. CEMETERY LOT NO Owner of Lot _
Section .-Grave No. .
BEARERS



p


S FUNERAL SERVICE RECORD
e (Lof t) ( D ase Middle)

(Name of Deceased)


OF DECEASED IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNTY: /
/y /

STATE::
/ yxy^


CITY: RES IENCE INSIDE
/~a- YES g[_ NO
STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION YES O NO '-
Relatipriship Syo*vors A 4 -,1
.r' I ---) ,

1.c / 1e

















CHURCH AFFILIATION -- /), / /-2 .
CLERGYMAN /,-


Address
FUNERAL


PA~CF y/ 4 4:P 7 PecJLAtr ATtbij > / S7


IF CHURCH, DID BODY LIE IN STATF YES& NO O
DATE 7 "-- >5 T. im : .
VISITING HOURS
FRATERNAL AFFILIATIONS SERVICE..YES ---..-NO



MUSIC YES O NO O
SINGERS


FUNERAL DIRECTED BY LICENSE NO.
EMBALMER'S LICENSE NO.
REMARKSz


NO. y-?Si/


I .. I


S /


...n.




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
(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 ........ ... .. ..




(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 (1)


Total (2)





Total (3)


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

Purchaser


STATEMENT MAILED


Estate: Yes 0
Executor or
Address
Attorney
Address


DATE


U//k1/16 1


LEDGER


LETTER SENT


_ ii _


No O Other:.. .. ........ .. .
Administrator. .. ......

. . . I . . . . . . . .


DEBITS


Aico Ib1


".....A0


IDEgE_


NO.


0


CREDITS BALANCE


--1-1


I I


"


I ----1


8-~BR






*(1) SERVICES, including Casket
All FacUlties and Equipment
Personal and Staff Service
Professional Services C o 8
Vitstors' Register
Acknowledgment Cards
Funeral Sedan
Casket Coach
Outside Enclosure .......-------.
Clothing .... -------
----.-----------------------------


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 ....... ----- -- ---
Teleg .. .......... ..
T.. ,---- --"" ----------
Lon stance Te phone Ca ...
Transportation ..-.- .......---.-
Flowers ........-----...- ..------
Obituary Notices -----------..
..................................
..................................
..................................


Total (2) /

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




Total (3)
Grand Total


ORIGINAL


FUNERAL PURCHASE AGREEMENT


i-v~


euuMhi's tu~wusza eom.
A. L. Cunningham, L.F.D. J. C. Cunningham, L.F.D.

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


Name of dece

Deceased is


based Age ]- A

; /-- of person arranging services
(Give relationship)

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

*(2) Items Involving Cash Advances ..... $/ 0 e

Total (1 & 2) r '

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


Terms of Payment: g.


Legal rate of interest after maturity.


We agree to furnish all services, and
merchandise, indicated above.


4

Signature of Co-signer with Purchaer


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


+ Grand Total $

, f d,


I, or we, accept and approve the above



Signature Purchaser





City State


Street City and State


Street City and State


Street City and State


Street City and State


___ _~


..------..JmL


4Y


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