Application for burial  October  Page  of  pplication for burial ash interment and scattering of ashes Consecutive burial number APPLICATION FOR Burial Ash Interment Scattering of ashes At Cemetery

Application for burial October Page of pplication for burial ash interment and scattering of ashes Consecutive burial number APPLICATION FOR Burial Ash Interment Scattering of ashes At Cemetery - Description

govtnz Application for application for burial z 9 October 2014 Page 2 of 2 CASKET DETAILS Casket lidurn size length x width x height Casket shape oblong shaped urn Handles ixed rop down Will the casket have wrappingstapa mats Yes max 1 No Ashes amily ID: 36594 Download Pdf

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Application for burial October Page of pplication for burial ash interment and scattering of ashes Consecutive burial number APPLICATION FOR Burial Ash Interment Scattering of ashes At Cemetery

govtnz Application for application for burial z 9 October 2014 Page 2 of 2 CASKET DETAILS Casket lidurn size length x width x height Casket shape oblong shaped urn Handles ixed rop down Will the casket have wrappingstapa mats Yes max 1 No Ashes amily

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Application for burial October Page of pplication for burial ash interment and scattering of ashes Consecutive burial number APPLICATION FOR Burial Ash Interment Scattering of ashes At Cemetery




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Presentation on theme: "Application for burial October Page of pplication for burial ash interment and scattering of ashes Consecutive burial number APPLICATION FOR Burial Ash Interment Scattering of ashes At Cemetery"— Presentation transcript:


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Application for burial 9 October 2014 Page 1 of 2 pplication for burial, ash interment and scattering of ashes Consecutive burial number: APPLICATION FOR: Burial Ash Interment Scattering of ashes At Cemetery $33/,&$176'(7$,/6 Mr Mrs Ms Miss Burial right holder Next of kin Other Full name of applicant: Address: Email Phone: Mobile: Relationship to deceased '(&($6('6'(7$,/6 Mr Mrs Ms Miss Gender: Male Female Full name of deceased : Known as: Age: Residential address (last known): Date of birth: Date of death Place of death: Ethnicity Religion:

Occupation: Was the cause of death a notifiable disease? Yes No If yes, please state BURIAL BOOKING DETAILS: Day: Date: Arrival time: AM/PM INTERMENT TYPE: First interment Reopen PLOT DETAILS: Area/Section: Block: Row: Plot: Depth of grave: single depth double depth triple depth under the berm
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Auckland Council, Private Bag 92300, Wellesley St, Auckland 1142, N ew Zealand Tel: 09 301 0101 aucklandcouncil.govt.nz Application for application for burial z 9 October 2014 Page 2 of 2 CASKET DETAILS: Casket lid/urn size length: x width: x height: Casket shape: oblong shaped urn

Handles: ixed rop down Will the casket have wrappings/tapa mats? Yes (max. 1) No Ashes: amily bringing Funeral director delivering held at crematorium GRAVESIDE DETAILS: Lowering equipment evice ticks and straps Sand: (max. 10 bags supplied by family es Family to backfill grave: es Funeral director to be present es Family to be present: es Expected n umber of attendees at cemetery: SPECIAL INSTRUCTIONS: )81(5$/',5(&7256'(7$,/6 Funeral director: Date: Funeral company: Signature of applicant Date: PRIVACY STATEMENT: The personal information that you provide in this form

will be held and protected by Auckland Council in accordance with our privacy policy (available at aucklandcouncil.govt.nz/privacy and at our libraries and service centres) and with the Privacy Act 1993. Our privacy policy explains how we may use and share your personal information in relation to any interaction you have with the council, and how you can access and correct that information. We recommend you familiarise yourself with this policy OFFICE USE ONLY: Charges Plot Completed forms Digging fee Burial rights holder agreement completed Yes No Oversize Authority to open a plot received

Yes No Chapel hire Burial plot guidelines form completed Yes No Lounge hire Chapel requirement form Yes No Other Flag colour: Total Payment: Charge FD Family to pay