Title: Funeral Record for Rackard, Pet
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Permanent Link: http://ufdc.ufl.edu/UF00039499/00001
 Material Information
Title: Funeral Record for Rackard, Pet
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Rackard, Pet ( 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: UF00039499
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.__


(La
<7?A e: At


FUNERAL SERVICE RECORD

i,^ -/


NO.0 /


(Middle)


PLACE OF DEATH
COUNTY:


(Nant of Deceased)
OF DECEASED IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNTY: 4'7 ? .// /


,/LeNGT//OFTA


CITY OR OWN;
IF OUTSIDE CORPORATE
LIMITS, WRITE .RURAL,: ( A'


FULL NAME OF
HOSPITAL OR INSTITUTION;
IF NOT EITHER, GIVE ADDRESS:


ZCi


LENGTH OF STAY
(in thi plap)

LENGTH OF S AY

B^ c/J *-


D TE OF month ) (Day) ( Hour) f

SEX COLO OR RACE I MARRIED O NEVER MARRIED
/-/- -4 i ? I O WIDOWED O DIVORCED (Specify)
DATE OF BIRTH AE I Months Days Hours Min.

L OCCUPATION KIND OF BUSINESS INDUSTRY

BIRT LACE (State or Foreign CoPtry) CITIZEN FW T COUNTRY?

FA R'S NAM / /


_i cr'e '_ 5 (- -S "- U
WAS DECEASED EVER IN U. S. ARMED FORCES? SOCIALVUITY NO.

INFORMANT / -

Address Relationship


CAUSE OF DEATH
AUTOPSY YES O NO

PHYSICIAN I, '- el.

Address
PLACE OF BURIAL Cremation or Removal I DATE


Cemetery z/6
Location
County -2/ State


/4 CITY LIMITS?
CITY: (|i.*-7 RESIDENCE INSIDE
-Al ^ _YESQ NOD
STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION / YES Q NO
Relationship Survivors
u, -AA),. Yte ^ .6 ,I5- Lo) 1-/y/ C^ --
/,/4 IV.- -/r7^ -4 1 Z ^^ ^
_*/_ _. 00Y ni,
______


'I'


* 1 e '.' I


-, f


U .1 U

/ ---- -- ----- --







I. -- f ^~


CHURCH AFFI Q/
CLERGYMAN .
Address


I .3


FUNERAL PLACE
IF CHURCH, DID BODY LIE IN STATF YES 2-- NO O
DATE Time '"? 10) 4
.1 -


VISITING HOURS
FRATERNAL AFFILIATIONS


SERVICE..YES .... NO


AAa d l.j A .9 d 'C.4

MUSIC YES O NO D
SINGERS



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


INTERNATIONAL ASSOCIATION OF MORTICIANS


STATE:


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


-2 ... ; = --


_Y,


-- I Ulr- I--~


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


^A


V f


STATE:


win


"'


/^ 19-9;




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 ..
C 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


Term s .............


Purchaser .. .. .. . .


Estate: Yes Q
Executor or
Address
Attorney
Address


No O Other: .........
Adm inistrator . ..... ...........


TI II


DATE


_- 2___ _7 6n__Q
__ __________- 4,-n-_ ) _


DEBITS


I--I-- 1 Ii..-----t--.--11-t ~---1-


CREDITS


BALANCE


Ei ________]E]


NO.


_~F






*(1) SERVICES, including Casket
All Fafltiea and Equipment
Personal and Starf Service
Prof~e onal services
visitor Register
Acknowledgment Cards
Funeral Medan
Cadet Coach
Outside a closure ...-........
Clothing -------------------- Z 7
..................................


Total (1)

*(2) ITEMS INVOLVING CASH ADVANCES
To Permit Us To Render A Better Service
We Have Advanced The Money On Thee
For Your Convenience.
Sales Tax ......--- ...-......
Additional Autos .....-.....---.--
Cemetery Charge --..........--
Clergyman ....------....---------
Telegrams ..-- ....----------
Long Distance Telephone Calls...
Transportation.............---
lower ---..--......--....-- .------
Obituary NotLee ..........-.....-
..................................





Total (2)

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





............... .........-....-...


Total (3) /
Grand Total


FUNERAL PURCHASE AGREEMENT






A. L. Cunningham, L.F.D. J. C. Cunningham, L.F.D.
PHONES: 622-7886 622-4251
r9 25 A lT A 111 A 'AT.A L. IYDTr A


NaiMe of deceased A. 2 N Z 6 le Aged 4

Deceased is / /- -" of person arranging services
(Give relationship)

*(1) Services, including merchandise ....... 6$

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

Total (1 & 2) $s Q *s

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


Terms of Payment: 'M ,


Leg4a rate of interest after maturity.


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


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

19 i


Street City and Sate


Street City and tate


Street City and State


Street City and Stat


/'- f




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