CORPORATION OF THE TOWNSHIP
OF LAKE OF THE WOODS
BERGLAND & MORSON
CEMETERIES
BOX 427, RAINY RIVER, ONTARIO
POW 1LO
INTERMENT RIGHTS OR CEMETERY
SUPPLIES AND/OR SERVICES
Fax 807-852-3529 Phone
807-852-3529
INTERMENT OF: (Last name, Given) __________________________________________________
INTERMENT RIGHTS HOLDER: _____________________________________________________
Date of Death ____________________________________ Internment Date_____________________
Date of Birth ________________________________Age____________
Sex Male ______Female______ Resident____ Non Resident_____
Internment Time_______________
Single Plot Required
__________ Owned_________
Casket______ Cremation________ Other half reserved for
_________________
Or
occupied by_________________________
Name of Purchaser____________________________________
Address_____________________________________________
_____________________________________________
Postal Code _______________
Name of Funeral Home ______________________________ Phone # ___________________
Church Service At ______________________________ Phone # ____________________
Graveside Service Yes____
No_____ Vault________ Box ______
Bergland Cemetery _________
Block/Row _______________________ Lot Number_______________________
Morson Cemetery __________
Block/Row ____________________ Lot Number ______________________
Internment Date_____________________ Foreman__________________________
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Costs
Plots Monuments
Lot (resident/non rdnt) $50/$75
Marking plots for monument placement $50.00
Plot Location Fee (burial) $50.00
Opening/closing fee $500.00 Care & Maintenance Under 172 sq in $0.00
Cremation - Urn (dig/locate) $50.00 Flat
Marker over 172 sq in $50.00
Foundation ______ Upright monument under 4 Ft. $100.00
Care & Maintenance $150.00 Over 4ft in height or width $200.00
Total ________ Received By ___________________
Receipt
No. ____________________
Date
_____________________
___________________________________________________________________________________________________________
It is agreed
between the parties that this contract is subject to the By-laws of the
Township of Lake of the Woods and the purchaser acknowledges receipt of a copy
of the Cemetery By-laws and that the "Conditions of Contract" on Page
2 attached hereto have been read and understood.
ORDERED BY: (signature) ____________________________________________
Clerk- Treasurer/designate:(signature) _____________________________________
CORPORATION OF THE TOWNSHIP OF LAKE OF THE WOODS
BERGLAND & MORSON CEMETERIES
BOX 427, RAINY RIVER, ONTARIO POW 1LO
INTERMENT RIGHTS OR CEMETERY SUPPLIES AND/OR SERVICES
CONDITIONS OF CONTRACT
1. 40% of the purchase price for Interment Rights or $150.00
(whichever is greater), will be set aside for care and maintenance.
2. The re-sale of Interment Rights by the Purchaser is strictly
prohibited under the Terms of this contract.
3. Should the
Purchaser wish to transfer an Interment Right, where, for the purposes of the
Governing Legislation, "transfer" means a gift, bequest, or any other
transfer made without consideration:
(a) The Purchaser shall give notice of the transfer to
the Cemetery Owner and return the original Certificate of Interment Rights to
the Cemetery Owner; and
(b) The Cemetery Owner shall issue a new Certificate of
Interment Rights to the Transferee.
4. The Cemetery Owner does not re-purchase
of the Interment Rights.
5. The operation of
the Bergland and Morson Cemeteries and the exercise of Interment Rights therein
are governed by By-law No
201 of the Township of
Lake of the Woods: purchasers are advised to refer to said By-law for further
details.
6. Included in said
By-law are certain restrictions regarding the erection or installation of
markers within the Bergland and Morson Cemeteries: purchasers are advised to
refer to said By-law for further details.
7, Prior to the exercise of an Interment Right, a Burial Permit or Cremation Certificate must be provided to the Cemetery Owner.
8. A Certificate of Interment Rights will not be issued until such
time as the Interment Rights have been paid in full.
I hereby
acknowledge that I have read and understand the above "Conditions of
Contract"
__________________________________________ ______________________________
Signature of
Purchaser Date
Page 2 of 2
Collection of
Information Notice:
Personal
information contained on these forms is collected pursuant to the Municipal
Act, 2001 and will be used for the purpose of selling interment rights or
cemetery supplies and/or services. Questions about the collection should be
directed to: THE FREEDOM OF
INFORMATION AND PRIVACY COORDINATOR, Township of Lake of the Woods, PO Box 427 Rainy River,
ON POW lLO (807) 852-3529.