APPLICATION FOR INTERMENT

Office use
Date received Approved Grave number
Grave number Cheque received Registration form received
Registration form sent to Registrar
Entered in burial book Entered on spreadsheet

Please print, complete and send to :
Neil Pocklington, Clerk to the Council,
The Verney Institute, 13 Newboundmill Lane, Pleasley, Mansfield Nottinghamshire NG19 7PL