Title: Funeral Record for Johnson, Mack
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Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00042404/00001
 Material Information
Title: Funeral Record for Johnson, Mack
Physical Description: Book
Language: English
Creator: Cunningham Funeral Home
Estate of Johnson, Mack ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1979
 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 #5375
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00042404
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


PLACE OF DEATH
COUNTY


FUNERAL SERVICE RECORD
(F (Middle)


STATE:


(Name of Deceased)
C OF DECEASED: IF INSTITUTION,
USUAL RESIDEC RESIDENCE BEFORE ADMISSION:
COUNTY: M c7 i


N O. -3

Telephone 7-

STATE:


CITY: R/7 I RESIDENCE INSIoD
CITY LIMITS?
YES 3 NO
STREET ADDRESS; / a RESIDENCE ON FARM
IF RURAL GIVE EXACT LOCATION 7 YES O NO
Relationship Survivors
W if j dden


WAS DECEASED EVER S. ARED FORCES? P R AEJ
-PRIVATE NFORITTION
INFORMANWV ;


V A


CHURCH AFFILIATE
CLERGYMAN
Address


AUTOPSY / n 1YES O NO S

PHYSICIAN 1 A '44U


Address


PLACE OF BURI remain l DATE
Cee... Ltery 19---
Location
County State
CEMETERY LOT NO. Owner of Lot
Section Grove No.
BEARERS







INTERNATIONAL ASSOCIATION OF MORTICIANS


FUNERAL PLACE Aliag Vr L i SLf


I --- ---
IF CHURCH, ID DY LI IN STf YES NO O
DATE 2a)V9e; T5me r, P
VISITING HOURS
FRATERNAL AFFILIATIONS SERVICE..YES ....NO



MUSIC YES [ NO O
SINGERS


FUNERAL DIRECTED BY LICENSE NO.
EMBALMER'S LIMS NO.
REMARKS: 4_4 v' !tW 7. 77 .


__&_YQ


Z-/cae


Y~`Z~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


(1. SERVICES, including casket
d Facilities and Equipment
Personal and Staff Service
Professional Service ..
Visitors Register ...
Acknowledgement C-.r.
Funeral Sedar
Casket Coach
Outside Enclosure .. .. .
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 ..


Total (1)


















Total (2)






Total (3)


CARRYING CHARGE
GRAND TOTAL

Terms ............ ....... .....................


Purchaser ......... .


STATEMENT MAILED


Estate: Yes O
Executor or
Address
Attorney
Address


DATE


LEDGER


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

. . . . . . . . . . .


DEBITS


CREDITS BALANCE


...7. 6-2 O ki.-



/ / 11 i -0 ._

___2


1-1 -


I


LETTER SENT





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 Coach
Outside Enclosure............. s *
Clothing ....................



Total (I)
(2) ITEMS INVOLVING CASH ADVANCES
To permit us to render a better service, we have
advanced the money on these for your conven-
ience.
Sales Tax .................. ..
Additional Autos.............
Cemetery Charges............
Clergyman ...................
Telegrams.....................
Long Distance Telephone Calls ..
Transportation ...............
Flowers......................
Obituary Notices................ .-
Programs ...................



..""""""""""""" --- <. 7.
Total (2) $ _
* (3) ITEMS ORDERED LATER
Certified Copies ...............







Total (3) $
GRAND TOTAL $


CUNNINGHAM S'

Funeral Home


J. C. CUNNINGHAM, L.F.D.

434 N.W. 16th Avenue


A. L. CUNNINGHAM, L.F.D.

* Ocala, Florida 32670 Phone (904) 732-5353


AgeZ-,


f /
Name of deceased /M r n' C T "__


Deceased is


(Give relationship)


of person arranging services.


* (I) Services, including merchandise ............. ~.

* (2) Items involving cash advances ............... $ ."
(3) Total of I & 2 ............................. $/ l .

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

(5) Total of 3 & 4 ............................. $

x GRAND TOTAL $

Terms of Payment: C ,.

Leal ra e of ie- -0,3 m ui -70.0

Legal rate of interest after maturity. 7- ?1'' 771'ZzA oe*
We~~~~~~~~~ agree tofrihal evcsondmrhnie


We agree to furnish all services, and merchandise,
merchandise, indicated above.


'4


I, or we, accept and approve the above


Signature o urchaser



City State
7J~* (5-g As'


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


f




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