Title: Funeral Record for Smith, Charlie
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Permanent Link: http://ufdc.ufl.edu/UF00042886/00001
 Material Information
Title: Funeral Record for Smith, Charlie
Physical Description: Book
Language: English
Creator: Cunningham Funeral Home
Estate of Smith, Charlie ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1983
 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 #5846
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00042886
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


S FUNERAL SERVICE RECORD D
(Laot) / (Fuf / (Middle)

S(Name eased)
US**U* I ,sn N ) `OF DECEASED: IF INSTITUTION,
USUAL RESIDE CE RESIDENCE BEFORE ADMISSION:
COUNTY: / /
STATE:


PLACE OF DEATH
COUNTY:


Telephone: 1. ~ '. 7

STATE:


CITY: RESIDENCE INSIDE
CITY LIMITS?
YES" NO.
STREET ADDRESS; RESIDENCE ON FARM?
IF RURAL GIVE EXACT LOCATION: /YES O NO D
Relationship Survivors
WifNW' den #


e\ -y f d .


____-- JZ55- -h9 ~ 7~4~'


35/ZLA4 d^/^ e. Pt A./d St


CAUSE OF DEATH
AUTOPSY

PHYSICIAN


CHURCH AFFILIATION
CLERGYMAN IV, 'Le""" / W/zSA;, t&&-


Ar, NO2


Address


FUNERAL PLACE
IF CHURCH IDID BODY LIE IN STATF YES NO __
DATE Tri.. &H
VISITING HOURS


FRATERNAL AFFILIATIONS


SERVICE. YES -..- NO Q


HbMAM--b


AddreuA 011 A-1 g --------
PLACE OF BUR or Re9 DATE
C. e,...ry IF
Location A
County LO / NO.OV So tate
CEMETERY LOT NO. Owner of Lot


,rave No. -


BEARERS


INTERNATIONAL ASSOCIATION OF MORTICIANS


Section


0


_I


F I -r -f


' "'"'UL"~ '-


- cg-I 4- -- --


_1z


I







DESCRIPTION OF CASKET AND OUTSIDE ENCLOSURE
LETTER SENT I


Estate: Yes [ No 0 Other: .....................................
Executor or Administrator ....................
Address ... ................................................ .
Attorney ....................... .................................
Address .... ............. .......... ........................
n n


DEBITS


CREDITS


BALANCE


00 -O
' t o_______ -- i s





_


NO.


S


i i


(1) SERVICES, including casket
All Facilities and Equipment
Personal and Staff Service ....
Profesional Service.
Visitors Regiter ...
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..
Flowers
Obituary Notices





(3) ITEMS ORDERED LATER
Certified Copies



CARRYING CHARGE


Total (1)















Total (2)





Total (3)

GRAND TOTAL


STATEMENT MAILED


LEDGER


PATE


--r,


SALES RECORD


II


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