Title: Funeral Record for Burley, Benjamin
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Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00042059/00001
 Material Information
Title: Funeral Record for Burley, Benjamin
Physical Description: Book
Creator: Cunningham Funeral Home
Estate of Burley, Benjamin ( 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: UF00042059
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
(2 Lost) (First)
J/;=&^A AZ -Iu^


(MIdMI)
-70.


(Name ofC sed)
7 Of CDICIOAS0: IF INSTITUTION.
USUAL RESIDENCE SIDmINE wFRE ADMIS *oo:
COUNTY 4 &)


O PLACE OF DEATH
COUNTYs


STATEs


Telephone

STATE. f 74a h


CITYi a .ioeCea oIMIooS


IF RURAL OIVe EXACT LOCATOW.N e YES I NO A
Relationship Survivors
Wit Maiden

(g -. (?& ^Lc /(L^^ kJ44


FATHER'S NAME

MOTHER'S MAIDEN NA

WAS DECEASED EVER I "U. S./ARMED FORCES? I SOCIAL SECURITY NO.


Ad( r Relationship

_32 I ,.,

CAUSE OF DEATH
AUTOPSY YES O NO O

PHYSICIAN

Address
PLACE OF BURIAL moval DATE


Location
County State
CEMETERY LOT NO. Owner of Lot
Section Grove No.
BEARERS


CHURCH AFFILIATION
CLERGYMAN
Address
FUNERAL PLACE
IF CHURCH, DID BODY LIE IN STATE YES O NO O
DATE Ti-e
VISITING HOURS
FRATERNAL AFFILIATIONS sERVICE..YES O....NO D




MUSIC YES O NO O
SINGERS



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


I I _




DESCRIPTION OF CASKET AND OUTSIDE ENCLOSURE


NO.


Purchase Date Size Our Number Interior No.
Mfr. Mfrn. No. Material Material
Casket Cost Blanket Cost Cover Finish Color
td 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
Proessioal Service
Visiton Register
Acknowledgement Cards
Funeral Sedan
Casket Coach
Outside Enclosure ...
Clothing ..... .




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






(3) ITEMS ORDERED LATER
Certiied Copies


Total (1)

















Total (2)





Total (3)


CARRYING CHARGE


GRAND TOTAL


TePurhaser .
Purchaer


Estate: Yes 0
Executor or
Address
Attorney
Address


No O Other: ............
Administrator


. . . . I . . I .


DATE


DEBITS


CREDITS BALANCE


0


--


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