Authorization for Interment

AUTHORIZATION FOR INTERMENT ISHPEMING CEMETERY ISHPEMING, MICHIGAN
I
, being the owner, heir, or assignee of the owner of
Lot
Block
Space
in the Ishpeming Cemetery, Ishperning, Michigan, do hereby authorize the interment of:
Deceased Name:
Place of Residency
Witness
Owner Heir or Assignee
Age
Date of Birth

MonthDayYear
Date
Date of Death

MonthDayYear
Date
Date of Delivery

MonthDayYear
Date
Time of Delivery
Clergy
Perpetual Care
Resident
Nonresident
Married
Single
Widowed
Veteran
Branch
Funeral Director
Should be Empty:

AUTHORIZATION FOR INTERMENT ISHPEMING CEMETERY ISHPEMING, MICHIGAN