Title: Funeral Record for Jenkins, Martha
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Permanent Link: http://ufdc.ufl.edu/UF00041521/00001
 Material Information
Title: Funeral Record for Jenkins, Martha
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Jenkins, Martha ( 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: UF00041521
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.


O PLACE OF DEATH
COUNTY:


FUNERAL SERVICE RECORD
(Last) (First)
z^a/^ I W)"


STATE:


(Middle)


(Name of Deceased)
USUAL R D N E OF DECEASED: INSTITUTION,
USUAL SINCE REDE CER ADMISSION:
COUNTY: 77,^, / -


N 0.o
NO.yr co

Telephone 7 712''

STATE:


CIT TOWN; LENGTH OF STAY
IF OUTSIDE CORPORATE (in this place)
LIMITS, WRITE "RURAL.(:n

FULL NAME OF LENGTH OF STAY
HOSPITAL OR INSTITUTION;
IF NOT EITHER, GIVE ADDRESS:
DATE OF ( th) (ay) (Year) (Hour)
DEATH
SEX / j OR OR RACE | MARRIb NEVER MARRIED
S I [f WIDOWED [ DIVORCED (Specify)
AGl A Mot I IIu
DA 0 BIRTH AG Months Days Hours Min.

USUAL P CUPAT1N /. KIND OF BUSINESS OR INDUSTRY

BIRTHPLACE tate or Foreign Country) CITIZEN OF WHAT COUNTRY?

FATHER'S AME Z-

MOTHER'S MAIDEN N

WAS DECEASED EVER IN U. S. ARED FORCES? ...........

INFORMANT

Address Relationship


CAUSE OF DEATH
AUTOPSY YES O NO ]

PHYSICIAN

Address
PLACE OF BURIAl /Crematip f Removal DATE
Cenetery r d 19
Location ./c I i -z,
County State
CEMETERY LOT NO. Owner of Lot


Section -
BEARERS


Grave No.


CITY: RESIDONC- INSIDE
CITY LIMIT
YES NOD
STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION YES O NO Q
Relationship Survivors

o I-
A TE .*- / r e m 0





















CHURCH AFFILIAON E
CLERGYMAN '
Address
FUNERAL PLACE 09& rr _
IF CHURCH, DID BODY LIE IN STATE YES O NO _
DATE /I 7 'm Tim r
VISITING HOURS
FRATERNAL AFFILIATIONS SERVICE..YES 0....NO D




MUSIC YES O NO
SINGERS



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


INTERNATIONAL ASSOCIATION OF MORTICIANS




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



CARRYING CHARGE


I


Total (1)
















Total (2)





Total (3)


GRAND TOTAL
Term s. .. ... . .

Purchaser


Estate: Yes O No O
Executor or Administrator
Address
Attorney
Address


DATE


NO.


Other:


DEBITS


CREDITS


BALANCE


iL~xJ I lj i (. I e0 7/ _
U


E li_ _____________________________ ____ ]


- I


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


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

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




FUNERAL PURCHASE AGREEMENT


You will not be charged for any of the items below
that you chose not to use.
*(1) Casket
Removal to Establishment
Preparation Preservation
Staff Service
Professional Service
Facilities Equipment ___ _
Obtaining Burial Permit
Visitors Register, Cards
Opening, Closing Grave
Conducting Services
Funeral Car Casket Coac
Outside Enclosure .............
Clothing ..................... -- 7-



Total (1) $ 24?
*(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 ............ .
Programs ................. -




Total (2) $ Ai41-
*(3) ITEMS ORDERED LATER
Certified Copies ..........







Total (3) 1
GRAND TOTAL $


Name of


Deceased is


CUNNINGHAM'S FUNERAL HOME
A. L. Cunningham, L.F.D. J. C. Cunningham, L.F.D.
PHONE: 732-5353
434 N. W. 16th AVENUE, OCALA, FLORIDA 32670

19

ed .y, z Age

Sof person arranging services
S Give relationship)
*(1) Services, including merchandise .......... $

*(2) Items Involving Cash Advances .......... $ 5

Total (1 & 2) / 3 1.


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


Legal rate of interest after maturity.


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






City State

Signature of Co-signer with Purchaser Street City and State

Signature of Co-signer with Purchaser Street City and State

Signature of Co-signer with Purchaser Street City and State

Signature of Co-signer with Purchaser Street City and State




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