Interment InstructionsThe Piqua Granite and Marble Co. Inc., Since 1882Lot Owners
Name______________________________________
Name of
Cemetery______________________________________ Address of Cemetery____________________________________ Section _______Lot Number_______ Number of Graves________________ Interments should
be made in graves Permanent Care
instructions of my lot …………………………………………………………….. My preference of Funeral Directors is …………………………………………………………….. Phone…............................ Date………………………........................... Signature of Lot Owner……........................................... |
PLOT DIAGRAM
Circle one of the above plots |