Property Owner Information Form

To be completed by the owner or authorized family member.


Required fields are indicated with an asterisk *

* Date of Form Submission: 

* Name of Property Owner(s): 

* DOB 1: 

  DOB 2: 

Name of Family Member of Record if Owner(s) are deceased:
*

Address:

* Street: 

* City: 

* State: 

* ZIP

Please provide at least one phone number.

* Phone: 
* Type:
  If this is a cell phone, may be text you?  YesNo

  Phone: 
  Type:  
  If this is a cell phone, may be text you?  YesNo

  Phone: 
  Type:  
  If this is a cell phone, may be text you?  YesNo

Please provide at least one email address.

* Email: 
  May we contact you via this email address?

  Email: 
  May we contact you via this email address?


Please carefully VERIFY THE FOLLOWING:

Please complete a separate form for each property owned.

* Location: Cedar Lawn Memorial ParkFair View Cemetery

* Lot: 

* Section: 

* Division: 

* Spaces: 

  Number of spaces used: 

  Spaces available: 

  Who will use any remaining spaces? 

* Has a reservation/assignment of space letter been completed?  YesNo


Space Assignment

Cedar Lawn Memorial Park

1 2 3 4
Space Name Relationship
1:
2:
3:
4:
Special notes or requests about your wishes and plans:

Fair View Cemetery

7 8 9 10 11 12
1 2 3 4 5 6
Space Name Relationship
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
Special notes or requests about your wishes and plans:

Did you know that there is an interest-free payment option available for pre-planning, saving you money?YesNoI would like to know more


Please check all that may apply to you:

Traditional Ground Burial

Spaces purchased and assigned

Vault(s) selected

Memorial/marker selected and designed relevant to location

Need to know if double interment is possible in one space

Cremation Options

Ground Burial  Two cremations can be placed per space with a second burial right

Cremation Niche  Two to eight cremations can be placed depending on location and style

Cremation Bench  One to four cremations can be placed in a memorial bench estate.

Cremation Vaults

Memorialization


I need to schedule an appointment with my Family Service Counselor for more information on pre-planning.

Call (540) 344-4263) or email srussell@thefairviewgroup.org.


*I verify that all information above is correct.

* Typed signature: 


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