Title: Funeral Record for Roberts, Mollie
CITATION THUMBNAILS PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/UF00041816/00001
 Material Information
Title: Funeral Record for Roberts, Mollie
Physical Description: Book
Language: English
Creator: Cunningham Funeral Home
Estate of Roberts, Mollie ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1976
 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 #4799
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00041816
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
-d -rov,


NO .70 9


(Middle)
'>t7vt^7L)


a(ltre of Deceased)


PLACE OF DEATH
COUNTY:

1V'9 A) 7L


STATE:

c:7Aa-v_


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

FULL NAME OF LENGTH OF STAY
HOSPITAL OR INSTITUTION;j'._, L
IF NOT EITHER, GIVE ADDRESS: N I, M A
DATE OF month) r (pay) (Yeor) (Hour)
DEATH :3 ///7 7
SEX R/ I 'OR OR RACE O MARRIED O NEVER MARRIED
_I WIDOWED [ DIVORCED (Specify)
DATE OF BI/H / Months Days Hours Min.


USUAL OC(UPn ION s If
rytJy) ^ Iu


IND OF BUSINESS OR IhUSTRY -


BIRTHPLACE (Statt ign CouIp) CITIZEN OF WHAT COUNTRY?

FATHER'S NAME

MOTHER'S MAIDEN

WAS DECEASED EVER IN ARMED FORCES?
_________. / 61E ,
INF!!__ __

Adsires Atelationship


CAUSE OF DEATH
AUTOPSY 1YES O o, OD

PHYSICIAN z/J 7 o / (a

Address
PLACE OF BURIAk. Cremation o Removal DATE
Cemetery <7z / 192L
Location
County State
CEMETERY LOT NO. Owner of Lot


Section


Grave No.


BEARERS







INTERNATIONAL ASSOCIATION OF MORTICIANS


OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNT )


Telephone

STATE: -


CITY: '' / RESIDENCE INSIDE
CITY LIMITS?
YES Q NO [D
STREET ADDRESS; --J / 7 RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATIONj / .YES O NO O
Relationship Survivors



f {/ I, 111 -1 /.,


~e3dZ~iDi,> 7u&~ I2,4~A -hd1


f0 AV,00 f 1,/L o 7


/ NOL^ ff-2-,X1 .1

(n 4-A" C J Jy Aj j^u'I tP I^T-/.,L )z-L


it Li~Ci t'~ii ID ,1J i

I


--V


CHURCH AFFILI ION .44L.2r c%
CLERGYMAN -+< 2 r
Address
FUNERAL PLACE
IF CHURCH, DID BODY LIE IN STATF YES [ NO O
DATE 7 Tim oe",7
VISITING HOURS
FRATERNAL AFFILIATIONS SERVICE..YES -....O O




MUSIC YES [ NO O
SINGERS


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


1.7-


I


I I


-- 1 w .


&tA'afW~tiji


-- --


'~----'--" ~ ---------- ----' --------


--


-


~L~c~


- f. ^ f -- cI


1, ` ors~lt


?C


A5_1Snf




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 T ax ................ ..
Additional Autos .
Cemetery Charges ....... ...
Clergyman ...
Telegram s ......... ....
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


_ I _


Estate: Yes [ No O Other: ....................... .... ...
Executor or Administrator.............................
Address ....
Attorney............................................................
A d d ress .. ...... ... ... .. .. .. ... ... ... ..
F1 l fl


DATE


DEBITS


CREDITS IMBALANCE


_3 76 ______ 2 __ /<)


[- f 337 _i. 15g







S- 1. \ te = I D
7-6






_W 2,7 .


____________________________________________________ I 11111


P urchaser ......... .. .. .. .. ..........


=__ _______ L


NO.





You will not be charged for any of the items below
that you chose not to use.
*(i) 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 Coach
Outside Enclosure .........
Clothing .....................
............................ a

Total (1) $ / P/
*(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) $
*(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
-., 27


19 Z_


Name of deceased / // r Age


Deceased is


of person arranging services


(Give relationship)
*(1) Services, including merchandise ..........$ / /


*(2) Items Involving Cash Advances .......... $ /OS"d 0 c

Total (1 & 2) $ "/r

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

GRAND TOTAL $/767-

Terms f Pay : 2nt- A e.
^'77 /'7 .rA A. .-,4 -.


Legal rate of interest after maturity

We agree to furnish all services, and
merchandise, ind ed above.




Ba JA


7I ,


I, or we, accept and approve the above


00 Signature of Purchaser "

/Address


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 tity and State

Signature of Co-signer with Purchaser Street City and State.


FUNERAL PURCHASE AGREEMENT


.1.1 -


dbp P~


Y


/


Byrc




University of Florida Home Page
© 2004 - 2010 University of Florida George A. Smathers Libraries.
All rights reserved.

Acceptable Use, Copyright, and Disclaimer Statement
Last updated October 10, 2010 - - mvs