The
Piqua Granite and Marble Co. Inc.,
Since 1882
Interment Instructions
Lot Owners Name______________________________________Name of
Cemetery______________________________________
Address of Cemetery____________________________________
Section _______Lot Number_______
Number of Graves________________
Interments should
be made in graves
(as indicated on the diagram)
as follows:
1.
…………………………………………………………
2.
…………………………………………………………
3.
…………………………………………………………
4.
…………………………………………………………
Permanent Care
instructions of my lot
have been made as follows:
……………………………………………………………..
My preference of Funeral Directors is
……………………………………………………………..
Phone…...........................................
Date………………………...........................
Signature of Lot Owner……...........................................
PLOT DIAGRAM
Circle one of the above plots