Title: Funeral Record for Johnson, Hattie
CITATION THUMBNAILS ZOOMABLE PAGE IMAGE
Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00040099/00001
 Material Information
Title: Funeral Record for Johnson, Hattie
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Johnson, Hattie ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1967
 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 #1987
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00040099
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.


RECORD


(Middle)


PLACE OF DEATH
COUNTY:


OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNT~ .

CITY:
^/./y r-^-r^^ ___


NO. /fe



STATE:

RESIDENCE INSIDE
CITY LIMITS?
YES [ NO L


STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION:/ YES --f0o O
Relationship Survivors






7n1 / ^A-sj i a


I~Ij


Iq


-I- --


Address Relationship


CAUSE OF DEATH
AUTOPSY YES L NO

PHYSICIAN -

Address

PLACE OF BU IA Cremation or Re oval DATE
Cemetery -. 19
Location
County .C. r State -_--- -'

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








INTERNATIONAL ASSOCIATION OF MORTICIANS


CHURCH AFFILIATION-
CLERGYMAN
Address (
FUNERAL PLACE
IF CHURCH, DID BODY LIE IN STATE YES NOD
DATE -- T -
VISITING HOURS
FRATERNAL AFFILIATIONS SERVICE..YES ---..-NO




MUSIC YES O NO [D
SINGERS



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


I


--




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 ..........
Clergyman .. .. .. ... ..
Telegrams .........
Long Distance Telephone Calls ... ....
Transportation .......
Flowers ... ..
Obituary Notices .............. ..






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



CARRYING CHARGE


Tot (1)
















Total (2)





Total (3)


GRAND TOTAL


T e rm s . . . . . . .. . . . . . . .

Purchaser
. .u .s . . . . . . . . .. I .. . .. . . . . .


Estate: Yes O No ] O their: .......... ...........................
Executor or Administrator .. ...................
A dd ress .... .. .............. ..............
A ttorn ey ... .. .... .. .... ... ... ... ... .. ... ... ... .. .... ... .. .... .. ... ..
Address .


DATE


DEBITS


CREDITS


BALANCE


LL
-- -






L .j ,> .


___________________________________ ___ I~I I _____ I*IIir


__________________________________________________ _______ ________ I _____






*(1) SERVICES, including Casket
All Facilites and Equipment
Personal and Staf Service
Proessional Services
Visitors Register
Acknowledgment Cards
Funeral Sedan
Casket Coach
Outside Enclosure............--
Clothing ....--------------------- -
...............................-.

-------------------------?f

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 Notices ----------------



.-..-.............------------_...


Total (2) / -

*(3) ITEMS ORDERED LATER oC0
Certified Copies ---------- --/ -




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


Total (3)
Grand Total j1(6 ,


FUNERAL PURCHASE AGREEMENT


A. L. Cunningham, L.F.D. J. C. Cunningham, L.F.D.
PHONES: 622-7886 622-4251
524 BROADWAY, OC FLORIA


Name of deceased UAge-

Deceased is J of person arranging services


(GiNe relationship)


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

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

Total (1 & 2) $

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

) Grand Total $

Terms of P, ent:


Legal rate of terest after maturity:

We a to furnish al services, and I, or we, accept and approve the above
chandise, indicated a ove.


Sig ture of Purchaser
I.
7117as
/'B/ S^"'*- ^ ~y /^\ ^-i N s
// / Z^";000-^


/

Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


Signature of Co-signer with Purchaser


-ctrt Cy a- State


Street City and State


Street City and State


Street City and State


Street City and State


/17




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