Cemetery Property/Interment Rights Buy Back Request -

Cemetery Property/Interment Rights Buy Back Request

Property Owner (s) / Requestor(s) Please list all Property Owners current information for records verification and updates
Date*

MonthDayYear
Date
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OwnerRequestor
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OwnerRequestor
Name*
Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Date of Birth

MonthDayYear
Date
Marital Status:*

SingleMarriedWidowedSRDP
Marital Status:

SingleMarriedWidowedSRDP
Please Choose:

OwnerRequestor
Please Choose:

OwnerRequestor
Name
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Phone Number
Please enter a valid phone number.
Date of Birth

MonthDayYear
Date
Date of Birth

MonthDayYear
Date
Marital Status:

SingleMarriedWidowedSRDP
Marital Status:

SingleMarriedWidowedSRDP
Property/Interment RIghts (including title and interest) to be considered Original Certificate of Ownership is*

AttachedLost
File Upload

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Lawn* Lot Grave
Lawn Lot Grave
I/we, property owners, hereby request Rose Hills' consideration to buy back the above listed cemetery property and understand that this is only a request for a buy back quote and in no way a final agreement on behalf of Rose Hills to purchase the property. Prior to any purchase, the Property Owner(s) must release all rights and interest in the cemetery property.
Name*
Signature*

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Rose Hills Memorial Park I 3888 Workman Mill Rd., Whittler CA 90601 I (562)463-4563
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