Certificate of Interment Rights - Dated 19 Oct 2013
For Glasgow Cemetery Association Inc.
This is a Non-perpetual Care Cemetery
Certificate Number:
Name of Purchaser(s):
Name of Seller:
Interment Spaces: Section: _ Row: _ Lot: ___ Grave Number:___ ______
Purchase price shall be: $ __________ cash at the time of purchase. All sales are final and binding by both parties.
Conditions of Interment:
1. The interment space(s) is to be used for interment purposes only, and the Purchaser’s rights are limited by and subject to the Cemetery’s rules and regulations as now existing or as amended in the future.
2. This certificate of interment rights conveys only a right to be interred in the interment space(s), and in no way is any real estate title conveyed to the Purchaser. Furthermore, only one interment will be permitted in the interment space unless specifically authorized by the Cemetery.
3. Services related to interment in the interment space(s) are not included in the rights conveyed and are subject to the Cemetery’s service charges and availability. These charges will be determined at the time they are purchased and are subject to change.
4. The Cemetery must receive the following information prior to any interment: a) The name of the deceased, b) The deceased’s birth date, c) The deceased’s date of death, d) Veteran status (Copy of DD214), e) Next-of-kin, f) Funeral establishment, g) Monument service (if any) and any other required information.
5. Purchaser has the right to sell and convey the interment space, but any transfer of ownership by will or otherwise will be recognized by the Cemetery only after it is recorded at the Cemetery and a new certificate of interment rights is issued to the new owner.
6. The Cemetery shall use the Purchaser’s address for any official notices concerning the interment space. The purchaser shall notify the cemetery, in writing, of any change in their address.
7. The terms and conditions described herein are binding upon the Purchaser’s heirs, successors and assigns and enforceable only by the Cemetery.
8. Purchaser shall furnish a permanent granite marker with foundation within twelve (12) months of burial and is responsible for all future maintenance of marker and foundation.
Purchaser’s Signature:
Purchaser’s Address:
Date:______________________
Cemetery Representative Signature:
Title or Authorization: _______ Date: _____
Attach:
Copy of Costs & Fees, Current Cemetery guidelines & floral policy, are subject to change or may updated periodical (Oct. 19, 2013).
Written inquires or complaints should be mailed to: Iowa Securities and regulated Industries Bureau, 330 Maple Street, Des Moines, Iowa 50319.
Glasgow Cemetery Association, Inc.
OWNERSHIP TRANSFER CERTIFICATE
DESCRIPTION OF INTERMENT RIGHTS Form Dated Oct, 19, 2013
[Description of Lot] __ Section: _ Row: _ Lot: ___ Grave Number:_______________
OWNER INFORMATION & ATTESTATION
Name: _____________________________________________________________
Address: _____________________________________________________________
_____________________________________________________________
I/We, hereby attest that I/we are the owner(s) of the above-described interment rights. I/We attest that no other person has any legal or equitable ownership interest therein. I/We relinquish all rights, interest and ownership therein and understand that this release and surrender is irrevocable.
I/We herby release and hold Glasgow Cemetery Association, Inc. and its employees, officers, affiliates and agents harmless and indemnify the cemetery against any and all damages, injuries, claims, causes of action, demands, or liability of any kind whatsoever arising in whole or in part from this transfer of ownership.
ASSIGNMENT OF RIGHTS AND OWNERSHIP
I/We do hereby irrevocably give, assign and transfer any and all interest in the above-described interment rights only to the following individual(s):
Name(s): _________________________________________________________
Address(s): _________________________________________________________
_________________________________________________________
TRANSFER OF OWNERSHIP BY CEMETERY
Fee $
Glasgow Cemetery Association, Inc. agrees to transfer ownership, record the transaction and issue ownership documents for the above-described interment rights to the following individual(s):
NAME: __________________________________________________________
ADDRESS: __________________________________________________________
__________________________________________________________
PHONE NUMBER(S): __________________________________________________
NAME: ___________________________________________________________
ADDRESS: ___________________________________________________________
____________________________________________________________
PHONE NUMBER(S): ___________________________________________________
This is a legally binding document for the irrevocable release and transfer of the above-described interment rights.
DATE OF TRANSFER: _________________________________________________
OWNER’S NAME: _________________________________________________
OWNER’S ADDRESS: _________________________________________________
_________________________________________________
OWNER’S PHONE NUMBER(S): __________________________________________
GLASGOW CEMETERY ASSOCIATION, INC.
BY: __________________________________________________________________
Signature and title of cemetery’s authorized individual