Lot Owner Authorization Form

CEDAR HILL CEMETERY
4111 Pennsylvania Ave. • Suitland, MD 20746 • (301) 568-1600
FOUNDATION ORDER
Date
To allow the installation of memorial on my/our lot in Cedar Hill Cemetery owned by.
known as Lot #
Section
Site(s)
.
Memorial to be set at the burial site of
.
(Deceased)
Granite Monument
The size of the monument is: (see also enclosed sketch)
Width
Length
Height
Die
X
X
Base
X
X
Monument Type
Material Type
Turf Top Memorial (Flat)
Bronze Manufacturer
Base Material
Granite Type
Length
mm
Height
Memorial
X
X
Base Size
X
X
To be installed by: Cedar Hill Cemetery.
Monument Dealer
Signature of Monument Dealer
Signature of Lot Owner
Address
Address
Telephone
Telephone
Monument Dealer must specify kind of stone to be used and enclose drawing to scale showing all dimensions, carving
and inscription.
Do Not Use Space Below
Approved,
(Administrator)
Laid off by _
Checked by
Completed,
. Amount of Charge
Paid
AUTHORITY 10 MEMORIALIZE
I/We
do hereby a t t e s t that I/We
authority
to purchase and i n s t a l l
meraorialization
who i s interred/entombed
of Cedar H i l l
have
the
for
in
Cemetery.
Lot or Crypt Designation
Further,
I/We
do hold cedar H i l l
harmless and accept a l l
I/We
Cemetery and i t s
management
r e s p o n s i b i l i t y for my/our a c t i o n .
understand that i n the event of a dispute between
owners, no refunds w i l l be issued i f
t h i s memorial must be
removed.
Date
Purchaser
Purchaser
Purchaser
AUTHORITY
lot
ADDENDUM TO CONTRACT
THE CEMETERY IS NOT RESPONSIBLE FOR
VANDALISM OR T H E F T ON T H E FOLLOWING
PRODUCT.
CAMEO PORTRAIT
DATE
Signature of Purchaser
Signature of Family Service Counselor