LITTON PARISH COUNCIL
NOTICE OF INTERMENT
To the Superintendent at Litton Cemetery:
PERSONAL DETAILS
Re the interment of the late (full name)
Of
Who died at
On
Aged
Occupation
Unmarried / Married / Widow / Widower (please circle as appropriate)
PARTICULARS OF GRAVE (please tick one box)
New grave

New Grave: (please tick one box)
Name of purchaser
Address of purchaser
Re-open

Single grave

Double grave

Re-open Grave:
Section
Plot No.
Name of person(s) already buried
Date of death(s)
Next of kin
Address
FUNERAL SERVICE
Service to be held at
Day, Date and Time
Interment at
Litton Cemetery, Litton
Day, Date and Time
Name of Undertakers
Name of Grave Digger to be used
Any Other Comments
Please ensure that the Certificate for Burial or Cremation is given to the Clerk to Litton Parish
Council on the day of burial.
Clerk to Litton Parish Council:
Ms G Turner, Rockingham Lodge, Market Square, Tideswell, Derbyshire, SK17 8LQ
Tel: 07548 195245