PENWORTHAM TOWN COUNCIL HILL ROAD BURIAL GROUND

THE ATTENTION OF THE APPLICANT MUST BE DRAWN TO THE FACT THAT PENWORTHAM BURIAL GROUND IS TO BE MAINTAINED AS A LAWNED BURIAL GROUND AND AS SUCH NO PLANTING OR KERBS WILL BE PERMITTED. FLOWER VASES MAY BE PROVIDED IF THESE ARE SUNK FLUSH WITH THE GROUND AND PLACED IMMEDIATELY IN FRONT OF ANY HEADSTONE, OR WHERE A HEADSTONE WOULD BE.

Grant no……….. NOTICE OF INTERMENT Burial no…………..

The Grant of Exclusive right of Burial MUST be produced at the time of giving this notice. In the event of the Grant being lost, a Statutory Declaration to this effect must be made before a Magistrate or a Commissioner of Oaths.

This notice is to be delivered at least two working days previous to any interment.

It is particularly requested that these particulars be carefully and accurately set forth.

GRAVE NO…………… DEPTH……………

DATE AND DAY OF INTERMENT………………………………………………..………..TIME………………

NAME OF DECEASED……………………………………………………………………………….…………..…

ADDRESS……………………………………………………………………………………………….………..….

…………………………………………………………………………………………………………………...……

AGE…………………. RANK / PROFESSION / TRADE etc…………………………..………………………….

PLACE WHERE DEATH OCCURRED……………………………………………………..………………………

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DATE OF DEATH…………………..…………………….. MINISTER………………………………………..…..

DENOMINATION……………………………………………………………………………………………………

PURCHASER’S NAME (in case of new grave)………………………………………………………………………

PURCHASER’S ADDRESS…………………………………………………………………………………………..

…………………………………………………………………………………………..……………………………

I HEREBY CONSENT TO THE INTERMENT OF;

…………………………………………………………………………………………………………….…………

IN THE PRIVATE GRAVE SPACE NO……………..…… IN SECTION…………………………..…………...

OWNER (name in full)………………………………………………………..………..DATE……………………

OUTSIDE DIMENSION OF COFFIN, LENGTH…………………… WIDTH………..………………………….

FUNERAL DIRECTOR……………………………………….………..TEL. NO……….………………………...

SIGNATURE OF APPLICANT…………………………………………………………..…………………......

GRAVE INDEMNITY

This part of the form should only be completed if the applicant is not the registered grave owner and either;

They are the named Executor of the deceased or, they are the deceased persons legal representative or next of kin and are applying to inter the remains of the grave owner.

In consideration of Penwortham Town Council permitting the re-opening the said grave space for the burial of the named deceased,

I……………………………………………….. of……………………………………………………………………………………….

Hereby undertake to indemnify the Penwortham Town Council from and against all actions, proceedings, loss, charges, damages, expenses, claims and demands which may be brought or made against the Council in consequence of the Council’s consent to open the specified grave and permitting the burial therein of the late ;-

………………………………………………………………………………………………………………………………………………

Signed………………………………………………………………………………. Date………………………………………………...

If you sign this indemnity the Council will permit the opening of the grave for burial purposes without production of the grave deed. However you must note that in signing you are giving an undertaking to bear all costs of the burial and the costs of any claim that may be brought by the owner or heirs to the owner of the grave, as a result of your claiming the rights to bury the remains of the aforementioned deceased.