Title: Funeral Record for Dempsey, Marilyn
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Permanent Link: http://ufdc.ufl.edu/UF00042790/00001
 Material Information
Title: Funeral Record for Dempsey, Marilyn
Physical Description: Book
Language: English
Creator: Cunningham Funeral Home
Estate of Dempsey, Marilyn ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1982
 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 #5753
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00042790
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_


(Last)
70 MAO 44


PLACE OF DEATH
COUNTY:


FUNERAL SERVICE RECORD
(First)
L .4 Ate, ,/ 9W


/ (Name of Deceosed)
OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE TFORE ADMISSION:
COUNTY: f
STATE: I r ,.
S CITY:
S/ A44 P/


CiTY OR TOWN; / 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 I ?J )4
DATE OF (M (Yr (Hour)
DEATH /W I
SEX C OR O RAE ~RRIED NEVER MARRIED
-/ / I W/,0,o WIDOWED 0 DIVORCED (Specify)
DATE OF BIRTH AGE Months Days Hours Min.


USU OCCUPATION/
.j, -t _


S OF BUSINESS OR INDUSTRY
e LSeo y/^^


BIRHPLACE (Stt or Foreign Country) CITN WHAT COUNTRY?

FATHER'S NAME'

MOTHER MAIDEN NAME

WAS DECEASED EVER IN U S ARMED FORCES? I nWIAI %pn-imiTrv W

INFORMANT




CAUSE OF DEATH
AUTOPSY YES O NO Q

PHYSICIAN

Address
PLACE OF BURIAL- Cremation or Removal DATE
Cemetery 3 &0 00M, AA WI4 e19&f
Location
County State
CEMETERY LOT NO. Owner of Lot
Section Grove No. -
BEARERS







INTERNATIONAL ASSOCIATION OF MORTICIANS


(Midd )
z^l>b I.


STREET ADDS; RESIDENCE ON FARM?
Relationship Survivor
Witfe' Maiden
ame






_, __ A b /b^ _r -


'fli--A- I 9E .LA'Aa. P..Q I'-a, M


CHR _____AFF GIL < 40







1ACCIIIA


CLERGYMAN .


1 *~j~ ~


Address


FUNERAL PLACE 7 4 4 b _AI4-f
IF CHURCH, DID BODY LIE IN STATE_ YES O NO [
DATE 7 / 0 0! ._im c C-t __


/
VISITING HOURS
FRATERNAL AFFILIATIONS


SERVICE .YES O.... NO n


r


I; -~ ~ -


. I


- -Y-


n~mAnn3


NO -7-3

Telephone: 1 7.L 3 /

STATE:

RESIDENCE INSIDE
CITY LIMITS?
YES O NO rt-


0 I v- f f- ~A 4


f


6-


-- -~




DESCRIPTION OF CASKET AND OUTSIDE ENCLOSURE
LETTER SENT I


Estate: Yes E No O Other: ... ...............
Executor or Administrator ... .. ............
A dd ress . ... ............ ... ..................... ... ... .
A attorney ..............................
A address .... .... .....................................................
DATE DEBITS CREDITS BALANCE


--- S
1^., J ]Q __ _3 -- -





















-


NO.


6/Y/83


SALES RECORD


(1) SERVICES, including casket
All Faciliti and Equipment ....
Personal and Staff Service
Professional Service .
Visitors Register ....
Acknowledgement Cards
Funeral Sedan ....
Casket Coach ..
Outside Enclosure ..
Clothing .......... .
C.o.... ....................




(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


Total (1)

















-Total (2)





Total (3)


GRAND TOTAL


STATEMENT MAILED


LEDGER





You will not be charged for any of the items
below that you chose not to use.
(1) Casket L-
Removal to Establishment
Preparation Preservation
Staff Service .
Professional Service 7
Facilities Equipment
Obtaining Burial Permit
Visitors Register, Cards
Opening, Closing Grave
Conducting Services
Funeral Car Casket Coach
Outside Enclosure.............
Clothing...................... 4, s



Total (1)
(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........................ ./ 7 .- Z
Obituary Notices...............
Programs .....................




,J.' Al 7Vk' 2(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


JL~aA,~ p


~em~naeu


Name of deceased _aOu L


Deceased is


(Give relationship)


of person arranging services.


* (1) Services, including merchandise............... % -,6
* (2) Items involving cash advances ...............
(3) Total of & 2 .............................
* (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 ............................ $
GRAND TOTAL $ Z

Terms of Payment: ,


Legal rate of interest after maturity.


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



s R / -f -,


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


19Q -


Age 7Z


I, or we, accept and approve the above


Signature of Purchaser


Address


I


- -----


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