Application Granting Permission for Burial

Application Granting Permission for Burial
Pursuant to the Certificate of Burial Right which Grantee rightfully holds, the Grantee hereby grants permission for the burial of

First NameLast Name
In the City of Orem Cemetery, Section:
Block Number:
Lot Number:
The person signing this application represents and warrants to the City of Orem that he/she has the authority to grant this permission and acknowledges that the City, its employees, agents, or representatives will not be held liable or responsible for any and all claims arising from this grant. By signing this application, the Grantee acknowledges that only one headstone may mark the burial lot, that no additional headstones or markers may be placed on the burial lot, and that the individual who has the right to the remains that are being interred is granted the authority to make all interment decisions including the selection of a headstone for the person being inferred.
Cremation Burial
Cremation Vault (If this is for a cremation fill this out)
Please note, Cremation vaults are not required. Cremains that are not buried in an approved vault cannot be recovered
Email
example@example.com
Signature
Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
NOTE: A copy of the Certificate of Burial Right must be filed with this Application
Should be Empty:

Cremation Burial