Title: Funeral Record for Harris, Lorenzo
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Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00041711/00001
 Material Information
Title: Funeral Record for Harris, Lorenzo
Physical Description: Book
Language: English
Creator: Cunningham Funeral Home
Estate of Harris, Lorenzo ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1975
 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 #4690
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00041711
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
,ast) (Frst)
I <^. Z/. <^.11

/ r


PLACE OF DEATH
COUNTY:


050.' F =Pp


STATE:


(Middle)


(Name of Deceased)
OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNTY: R E ER


NO. 46`90

Telephone, 7 .

STATE:


CITY OR TOWN; I / LENGTH OF STAY
IF OUTSIDE CORPORATE (in this place)
LIMITS, WRITE "RURAL":

FULL NAME OF LENGTH OF STAY


HOSPITAL OR INSTITUTION; /


-, /


IF NOT EITHER, GIVE ADDRESS: ',7 / /
DATE OF (M nth) (pay) (Year) (Hour)
DEATH '
SEX COlOR OR RACE O MARRIED O NEVER MARRIED
I e- I4" TOWEDD O DIVORCED (Specify)
D"T ', AGE Months Days Hours Min.
% ik oq ___


USL O PATION


I i E(Stat or Foreign Country) CITIZEN Y T HAT COUNTRY?

FATHER'S NAME

MOTHER'S MAIDEN NAME X

WAS DECEASED EVER IN U. S. ABRE)RCES? I r.,.

INFORMANT /1 0 /

Address R ip


CAUSE OF DEATH
AUTOPSY YES NO

PHYSICIAN

Address


CITY: RESIDENCE INSIDE
CI1LIgU


STREET ADDRESS; f
IF RURAL GIVE EXACT LOCATION: !f( I rt '


RESIDENCE ON FARM?
YES n N&


Relationship / Survivors :F 4 "
/I .//.//., ." ('- C-41 -A x d r. < ,,C.


_/'-" __.- "_--



/ ~/I ./ el


'---- ._.








CHURCH AFFILIATION
CLERGYMAN e-S
Address 0- *7
FUNERAL PL.
IF CHURCH, D D BODY LIE IN STATE YES 0 NO
DATEING HOS T
VISITING HOURS


PLACE OF BURIAL Crematon 9r Remove / DATE
Cemetery io / //L // .i / -L i / 192 -
Location


County


FRATERNAL AFFILIATIONS


OEKYIri.c


-YES ...--NO


State


CEMETERY LOT NO. Owner of Lot


Section


Grave No.


BEARERS


MUSIC YES O NO C]
SINGERS



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


INTERNATIONAL ASSOCIATION OF MORTICIANS


'q.


------- --


I-


-A


CEMETERY LOT NO. Owner of Lot


y ~L~


^IV^


7U


-- -.4


F


r


KINDOF BUSINESS O5 -NDUSRY/- /
'\0^/^- _; }




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




(2) ITEMS involving Cash Advances
Sales T ax .............. .. ..
Additional Autos .. .... ....
Cemetery Charges .... ...... ......
Clergyman ....... .. ..
Telegrams......
Long Distance Telephone Calls ........ .
Transportation .............
Flowers
Obituary Notices .......... .........






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




CARRYING CHARGE


Terms .


Total (1)


Total (2)





Total (3)


GRAND TOTAL


STATEMENT MAILED


LEDGER


LETTER SENT


_ _I _


Estate: Yes O No [ Other:..................................
Executor or Administrator .........................
A d d ress ..... .. ... ... .. .. . .. ... .. ... . .. . ... ..
A tto rn ey. .. . .. . .. . . . .. . .. . . . .. . .
Address ..................... .................. ..............


Purchaser ......... ............ .................................... __


NO.





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 ,d_ -. _9
Obtaining Burial Permit
Visitors Register, Cards
Opening, Closing Grave
Conducting Services
Funeral Car 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 .................
Telegrams .................. __
Long Distance Telephone Calls..
Transportation ...............
Flow ers ....................
Obituary Notices ............ -*
Programs ................. .




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







Total (3) $
GRAND TOTAL $


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

/6 cF^4A


Name of deceased 2 2.- 7


Age


Deceased is '^' of person arranging services
(Give relationship)
(1) Services, including merchandise .........$ z d. c

*(2) Items Involving Cash Advances .......... .$ ( J,

Total (1 & 2)

*(3) Items ordered later ....................$ CIO 7
Both parties agree any items ordered later
shall become a part of this agreement and
shall be inserted therein.


GRAND TOTAL $S._ >. O

Lcr S;1


Legal rate of interest after maturity.


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 Citv and IZI,-


FUNERAL PURCHASE AGREEMENT


Terms Pay n


/ j,19 .




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