KING’S SOMBORNE PARISH COUNCIL AND BURIAL AUTHORITY Peter Storey OBE FCIS Clerk to the Council Tel/Fax- 01794 389688 Email: kingssomborne.pc@btconnect.com c/o 2 Old Fromans Farm King’s Somborne Stockbridge Hampshire SO20 6QD NOTICE OF INTERMENT IN KING’S SOMBORNE CEMETERY THIS NOTICE to be delivered to the above address, to arrive NORMALLY TWO CLEAR WORKING DAYS before the pre-arranged time for the interment, together with the appropriate fee and the “Registrar’s Certificate for Disposal”, “Coroner’s Order for Burial” or “Certificate of Cremation”. HOURS OF BURIAL: All interments shall take place on Mondays to Fridays between the hours of 0900 and 1530 and on Saturdays between the hours of 0900 and 1200. No funerals on Sundays or Public Holidays, except in special cases sanctioned by the Council (or a Committee thereof) and in cases of emergency by Order of the Coroner. 1. Full name of Deceased: ................................................................................................................. 2. (a) Place where death occurred: .................................................................................................... ............................................................................................................................................................ (b) Last permanent address of Deceased: ..................................................................................... ............................................................................................................................................................ (c) Age of Deceased: ................................... Sex: ................................ Title............................... 3. Occupation: ................................................................................................................................. (if a minor, name and residence of parents): ...................................................................................... ............................................................................................................................................................ 4. Date of Death: ............................................................................................................................... 5. State whether a Parishioner of King’s Somborne YES/NO 6. Date and time of burial: ...............................................................................at.................am./p.m. 7. Description of grave required SINGLE/DOUBLE DEPTH/ASHES delete as appropriate (minimum depths for burials: double 6 feet 6 inches, single 5 feet) 8. Number of Grave Plot: New Grave No....................................Re-open Grave No....................... 9. Stonemason authorised to remove memorial (if applicable)........................................................... 10. Name of officiating Minister: ....................................................................Denomination: ........... 11. Name and address of Next of Kin................................................................................................. .............................................................................................................................................................. 12. Signature of Funeral Director: ........................................................................................................ Address: ................................................................................................................................................ ................................................................................................................................................................ Date ....................................................................................................................................................... Fees paid: Interment fee £............... Exclusive Right of Burial for 30 years £.............. TOTAL £.......:…........... The appropriate section overleaf is to be completed APPLICATION FOR OWNERSHIP – NEW GRAVE I wish to purchase the Right of Burial in the aforementioned grave and I understand that my rights will exist for a period of 30 years and that the Parish Council will have the right to remove any memorial from the grave after this period unless a second 30 year period has been purchased. I understand that a memorial can only be erected upon issue of the necessary permit from the Parish Council. I undertake to notify the Parish Council of any change in my address. Signed: ...........................................................................................Date........................................... Full Name of person to be registered as owner: ................................................................................ (block letters) Address: ......................................................................................................................................... ........................................................................................................................................................ ...........................................................................................................Post Code.............................. Note: No memorial erection may be arranged and no further interment may take place without the signed consent of the grave owner. RE-OPENED GRAVE I hereby authorise Grave No. ......................... to be re-opened for this interment. Full Name (block letters): ................................................................................................................... Address: ......................................................................................................................................... ........................................................................................................................................................ ....................................................................................................................................................... Relationship to the deceased: ........................................................................................................... Signature of registered owner or person authorised: ......................................................................... Date................ Number of Grant of Exclusive Rights of Burial for above Grave: ......................................................... UNPURCHASED GRAVE I, the undersigned person, agree to the interment of the late:- ...................................................................................................................................................... taking place in an Unpurchased Grave, in which other persons are or may be buried. I understand that no memorials will be allowed on this grave as the exclusive right of burial is vested in the Parish Council. Signed: ..........................................................................................Date............................................ Full Name (block letters): ................................................................................................................... Address: ......................................................................................................................................... ....................................................................................................................................................... Relationship to the deceased: ........................................................................................................ Only the appropriate section is to be completed |