CEMETERY LOT/BURIAL RIGHTS TRANSFER APPLICATION
(Print or type and attach additional sheets if necessary, fully answering the following questions.)
Date:
Name of Petitioner(s) Complete Address Phone Number
Cemetery: Lot: Block: Section:
List the number of available spaces by giving the space numbers (note: only available spaces are
transferable):
1. Are you the lot owner? Yes No (If yes, skip to
question 7).
2. Name of lot owner(s) on record. (If there is more than one lot owner on record, please
attach on additional sheets of paper the same information below on each one):
3. Is the lot owner(s) living? Yes No Spouse living? Yes No
4. If lot owner (s) is deceased, was there a Last Will and Testament? Yes No
(Please attach a copy)
5. Relationship to the lot owner (s):
Spouse Executor of Estate Power of Attorney Heir Other
6. List all
surviving heir(s) of lot owner: spouse, children, grandchildren, great-
grandchildren, etc.:
Name, Relationship and Address
NOTE: If there are no direct heirs (spouse, children, grandchildren, great-grandchildren,
etc.), indirect heirs (parents, siblings, nieces, and nephews, etc.), may inherit the burial
rights: however, the petitioner (s) must demonstrate beyond a reasonable doubt that they
are appropriate heirs. The petitioner(s) must show that no other living person is more
closely related to the lot owner of record.
7. List the names(s) of the individual(s) who the vacant spaces will be transferred to:
NAME ADDRESS STATE ZIP CODE WHICH SPACE#?
All persons with rightful owner-interest must agree to cemetery lot/burial rights
transfer request and will need to attach a notarized statement(s) stating they have
no objections to the transfer.
I certify that the information provided on this form and all of its attachments is truthful,
accurate and complete to the best of my knowledge, understanding and ability. I
understand that any false information will null and void any transactions which have
been made as a result from the information provided.
Petitioner Date
Petitioner
Petitioner
Notary Public
FOR OFFICE USE ONLY
Verified information with Cemetery Director
Verified in Office of the Clerk of Council
Date:
Date:
Initial:
Initial:
NOTE:
PLEASE RETURN FORM AND ALL ATTACHMENTS TO
THE OFFICE OF THE CLERK OF COUNCIL
P.O. BOX 1027
SAVANNAH, GA 31402
912-651-6441