Lot Owner / Family Member 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: CellHomeWork If this is a cell phone, may be text you? YesNo Phone: Type: HomeWorkCell If this is a cell phone, may be text you? YesNo Phone: Type: WorkCellHome 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? YesNo Email: May we contact you via this email address? YesNo 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 ntipton@thefairviewgroup.org. *I verify that all information above is correct. * Typed signature: Please type the characters above in the blank below. *