Online Notice of Interment

This form is to be used by Funeral Directors and/or Families when making arrangements for an interment in Narborough Cemetery.

Please complete this form and Submit AT LEAST 5 WORKING DAYS prior to interment.

Interments may take place on week-days only, excluding Bank Holidays, between the hours of 09.30 and 14.30. The Cemetery gates will be closed during interments to provide privacy to families/friends

* Required Field

SECTION 1 - DETAILS OF DECEASED

Enter details of deceased person

Title*:

Name*:

Address*:

Postcode*:

Date of Birth*:

Date of Death*:

Age*:

Place of Death*:

Profession*:

Interment of*:

(Body or Cremated Remains)

SECTION 2 - DETAILS OF APPLICANT

Enter details of the person arranging the funeral

Title*:

Name*:

Address*:

Postcode*:

Telephone Number*:

(no spaces)

Mobile Number*:

(no spaces)

Email Address:

Relationship to Deceased*:

SECTION 3 - DETAILS OF FUNERAL DIRECTOR

Name of Funeral Directors:

Contact Name:

Address:

Postcode:

Telephone Number:

(no spaces)

Email Address:

Name of Minister/Person who will Officiate*:

Electronic Signature of Funeral Director:

By signing your name electronically on this application form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form

Date of Signature:

SECTION 4 - DETAILS OF GRAVE

Grave Number*:

Is the the 1st Interment into the Grave?*

Yes No

Proposed Depth of this Interment*:

(Full Burial - 9ft, 7ft or 5 ft or Cremated Remains - 2ft)

Coffin Size & Material - (Please state type of measurement ie. imperial or metric)

Length*:

Depth*:

Width*:

Material*:

e.g. Wooden, Reed, Cardboard etc

SECTION 4a - NEW GRAVE

Complete this Section if this is a New Grave, otherwise go to SECTION 4b for an Existing grave.

This information will be recorded in Statutory Registers and used to produce a legally binding Deed of Grant for Exclusive Rights of Burial

Is the Deed to be issued in the name of the Applicant?

Yes No

If NO, please complete the following details of who will be the registered Deed Owner

Title:

Name:

Address:

Postcode:

Electronic Signature of Applicant of New Deed:

By signing your name electronically on this application form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form

Date of Signature:

SECTION 4b - EXISTING GRAVE

The person (s) registered as the owner of the Deed of Grant MUST SIGN the following declaration before an interment can take place (unless the owner is the deceased). The original Deed of Grant MUST BE provided with this form or if this is not possible, please contact the Parish Office 0116 286 3008, for further advice

Deed Number:

Name of Owner:

Address of Owner:

Postcode:

Electronic Signature of Owner:

By signing your name electronically on this application form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form

Date Signed:

SECTION 5 - INTERMENT DETAILS

DAY*:

DATE & TIME*:

Any personal data that you provide will be processed in accordance with current data protection laws. It will be used by Narborough Parish Council and our partners to deliver and improve services and fulfil our legal duties. We will not disclose any personal information to any other persons unless required or allowed to do so by law. You can read more about how we use personal data in our Privacy Notice on our website

I HAVE READ AND UNDERSTAND THE RULES & REGULATIONS AND HEREBY AGREE TO BE BOUND BY THEM

I UNDERSTAND THAT PAYMENT OF ALL FEES & CHARGES DUE FOR THE PROVISION OF BURIAL SERVICES IS MY RESPONSIBILITY AS THE APPLICANT

Electronic Signature of Applicant*:

By signing your name electronically on this application form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form

Date of Signature*:

SECTION 6 - PAYMENT DETAILS

Please make online payment (Faster Payments) using the details below

Name of Bank - Nat West Bank

Name of Account - Narborough Parish Council

Sort Code - 60-60-06

Account Number - 15092720

Reference - Invoice Number, Plot Number & Name of Interred

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