To: Agudas Achim Cemetery Committee
In keeping with Orthodox Jewish law and practice that sacred objects that are no longer
fit for use should be buried in Jewish cemetery grounds,
And appreciating that it is an honor to have such objects placed in the grave with the
body of one who is about to be interred,
The Undersigned hereby consent(s) to allow Congregation Agudas Achim to
place such sacred items that require burial in the plot(s) held in the name(s) that appear
below.
Please Print
Name(s) of Owner(s) of Plot(s)
Signature
Date
Contact information of responsible party ____________________________
Street Address
_____________________________
City/State/Zip Code
Relationship to the owner(s) of the plot(s)____________________________
Telephone:___________________________