Title: Funeral Record for Johnson, Robert
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Permanent Link: http://ufdc.ufl.edu/UF00043143/00001
 Material Information
Title: Funeral Record for Johnson, Robert
Physical Description: Book
Language: English
Creator: Cunningham Funeral Home
Estate of Johnson, Robert ( Estate )
Publisher: Cunningham Funeral Home
Publication Date: 1984
 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 #6110
Funding: Funded in part by the PALMM Florida Heritage Project.
 Record Information
Bibliographic ID: UF00043143
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
eIItIIA *L IEl


UB RIAL PERMIT NO


I_ LI_


. PLACE OF DEATH
COUNTY


(Name of Deceased)
OF DECEASED: IF INSTITUTION,
USUAL RESIDENCE RESIDENCE BEFORE ADMISSION:
COUNTY: / J
_) A^j/lre el


FUNERAL SERVICE RECO
"as 2 _' (Middle)


STATE: /


CAUSE OF DEATH
AUTOPSY


YES [


NO O


PHYSICIAN

Addrs.


PLACE OF BURIAL cremation or oval DATE
Cemetery-- 19 '
Location
County State
CEMETERY LOT NO. Owner of Lot
Section Grave No.
BEARERS e







INTERNATIONAL ASSOCIATION OF MORTICIANS


CITY: RESIDENCE INSIDE
T ) / e CITY LIMITS?
SYES G.i NO 3
STREE"DDRESS; -RESIDENCE ON FARM?
IF RURAL GIVE EXACT L TION: / Z YES [ .-NO
Relationship Survivors
Wife's Maiden


CHURCH AFFILIATION S
CLERGYMAN '. / <
Address
FUNERAL PLACE
IF CHURCH ID BODY LIE IN TAT YES NO __
DATE 7 / -. i "
VISITING HOURS
FRATERNAL AFFILIATIONS 5ERVICE..YES ... NO 0
REMARKS


NO. /0 -

Telephone: 1 r, /1/3 ."


__ __


^


STATE:




DESCRIPTION OF CASKET AND OUTSIDE ENCLOSURE
LETTER NT I


Estate: Yes [ No 0 Other: .................................
Executor or Administrator .. .........................
A dd ress ... ... ..................................................
A attorney .. ..............................
A d d ress .. .... ......... ..... .. ......

DATE DEBITS CREDITS BALANCE
^V- -0


(1) SERVICES, including casket
All Facilities and Squipment ....
Personal and Staff Service
Pressional Service ..
Visitors Register ...
Acknowledgement Cards
Funeral Sedan .....
Casket Coach ..
Outside Enclosure ...
C 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 .


STATEMENT MAILED


CARRYING CHARGE


GRAND TOTAL


LEDGER


NO.





1S1 RECORD














Total (1)

















Total (2)





Total (3)




You will not be charged for any of the items
below that you chose not to use. -.
*(1) Casket P
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.....................



Total (1) OQ
(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 ................ /4 6 a
Flowers ...................... li' o
Obituary Notices............... 31 *
Programs ..................... f *



."""""""""""" '"---............00
Total (2)
* (3) ITEMS ORDERED LATER
Certified Copies ...............







Total (3) $
GRAND TOTAL S


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


Name / 9 Age


Deceased is


(Give relationship)


of person arranging services.


* (1) Services, including merchandise .............. m4' 0
* (2) Items involving cash advances ............... t X 6
(3) Total of 1 & 2............................ 8 C<
* (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 $ 136 .9',


Le al rate of interest after maturity.

We agree to furnish all services, and merchandise, I, or we, accept and approve the above
merchandise, indicated above. )

/ Signature of urchaser


Address


City 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

Signature of Co-signer with Purchaser Street City and State




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