To Longparish Parish Council

This Notice is to be delivered between the hours of 9 in the Forenoon and 4 in the Afternoon, at the Office of the above-named , at least three days previous to any Interment. If the Interment is to take place in a Vault, or Bricked Grave, then three days, in every case exclusive of Sunday. No applications as to Burials can be received on Sundays.

It is particularly requested that the several particulars may be carefully and accurately set forth.

1. - Christian Name or Names and Surname of Person to be buried

2. - Description (as to Profession, Trade, &c.) of the Person to be buried (if a Minor, Name and Residence of Parents)

3. - Age of Person to be buried (if in years, last Birthday)

4. - Date of Death (Day of the Month and Year)

5. - Parish in which the Death occurred

6. - Day of the Week, and Date of the Month on which the Burial is to take place

7. - Hour of the Day at which the Funeral will arrive at the Burial Ground

8. - Name of the Minister intended to officiate

9. - Marks of Grave-space intended to be occupied

10. - Whether in the Consecrated or Unconsecrated Ground

11. - Whether in an Unbricked Grave, Bricked Grave, or Vault

12. - Whether the Exclusive Right of Burial in Perpetuity, or for a Limited Period, is purchased (if limited, state what period)

13. - If in a Purchased Grave or Vault, Signature of the present Owner

14. - Proposed Depth of Grave

Signature of Applicant


Cat. No. Bur.
SHAW & SONS Ltd., Shaway House, Lower Sydenham, SE26 5AE S1812 (H) L

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