Please state Information would include special family, personal or historical association between the details or the deceased person and the place in which the remains are to be buried or placed; or reason for some other special reason burial outside the designated cemetery Details of Lot Plan Parish location of the burial site Is the land Freehold Leasehold Other (please circle) Street Address (if applicable) Do you own the land YES/NO Please circle If yes please attach copy of rates notice. If no please attach written authorisation from the Land Owner. Burial Details Details of how and when the remains are to be buried including date and time
Please state the details or reason for burial outside the designated cemetery Information would include special family, personal or historical association between the deceased person and the place in which the remains are to be buried or placed; or some other special reason Details of location of the burial site Lot Plan Parish Is the land Freehold Leasehold Other (please circle) Street Address (if applicable) Do you own the land YES/NO Please circle If yes please attach copy of rates notice. If no please attach written authorisation from the Land Owner. Burial Details Details of how and when the remains are to be buried including date and time