APPLICATION FOR THE RESERVATION OF A GRAVESPACE/CREMATION PLOT
When completed please return to M Allanson Diocesan Registrar, 8 & 9 the Quadrant, Coventry,
CV1 2EG (telephone 024 76227331) with the Faculty Fee (see note 9 below).
NAME OF PARISH IN WHICH SPACE TO BE RESERVED (Please complete in every case)
……………………………………………………………………..
1.
Please supply the FULL NAME
Address and Occupation of the Petitioner and
State whether a parishioner or non-parishioner.
2.
Please supply the full name of the person
In the adjoining space to be reserved with date of burial:
3.
What relation if any is the Petitioner to the
Person in the space adjoining the one to be reserved?
4.
Is the space which it proposed to have reserved
An ordinary earth grave, brick grave, vault or cremation plot?
5.
Who is to be buried in the space to be reserved?
(Please give FULL NAMES)
6.
Please give the exact measurements of the space to
Be reserved and the grave/plot number.
7.
A Sketch plan of the churchyard MUST BE SUPPLIED with this form showing the position in
relation to the church of the space/plot to be reserved and having a North pointer thereon
8.
Attached to this form is a Certificate which must be completed by the Incumbent and
Churchwardens stating that the space can be reserved without detriment to the rights of the
Parishioners, having regard to the yearly number of burials and spaces available for burial.
This must be returned with the Application Form. It also gives the Incumbent's consent in
writing.
9.
The Faculty Fee (from the 1st January 2015) is £244.60 and a cheque payable to ROTHERHAM
& CO must accompany the Application Form. PLEASE NOTE: this fee increases annually on
the 1st January - if you have been given this form by the Incumbent or Churchwardens please
ensure the fee shown is the current fee.
10.
By suggestion of the Chancellor a donation is also payable as follows:
For Parishioners
The Incumbent £50
and
The Churchyard Fund of the PCC £50 Total £100
and
The Churchyard Fund of the PCC £100 Total £200
For Non-Parishioners
The Incumbent £100
Please note: these fees are in addition to the statutory fee shown at (9).
Signed …………………………………………………………………………………...(Petitioner(s))
Dated
……………………………………………………….
CERTIFICATE OF CONSENT FOR THE RESERVATION OF A GRAVESPACE/CREMATION
PLOT
I,
being the Incumbent (or Rural Dean in the case of an interregnum) of the Parish of
In the Diocese of Coventry HEREBY GIVE MY CONSENT to the reservation and
appropriation of a GRAVESPACE/CREMATION PLOT (please delete as appropriate)
in (name of )
churchyard
for the use of: (please state full names and addresses of those intending to be buried in the
space reserved)
Signed ………………………………………………………
Dated ………………………………………………………
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WE, the undersigned being the Incumbent and Churchwardens of the Parish of:
…………………………………………… in the Diocese of Coventry DO HEREBY
CERTIFY that in our opinion having regard to the average yearly number of burials in
the Churchyard of:
………………………………………….aforesaid the granting of a Faculty to the
aforementioned petitioners will not be detrimental to the rights of the Parishioners.
DATED:
…………………………………………………. Churchwardens (full names please)
………………………………………………….
…………………………………………………. Incumbent (or Rural Dean)