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:
      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? 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

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    Space

    Name

    Relationship

    1:

    2:

    3:

    4:

    Special notes or requests about your wishes and plans:

    Fair View Cemetery

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    10

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    12

    1

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    Space

    Name

    Relationship

    1:

    2:

    3:

    4:

    5:

    6:

    7:

    8:

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    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: 

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